HomeMy WebLinkAboutHomestead_Smith (86) H. PREPARER
Preparer of the Sales Disclosure Form Title
Escrow Officer
Matthew Jarvis
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2— Name as it appears on conveyance document
Home Smith Home LLC, an Indiana limited liability company
Address (number and street) Address (number and street)
1497 E.Taftown Rd.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 '
Country Country
United States of America Telephone number
E-mail address
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Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief, is true, correct and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
f l^;% Signature of Seller
rt..4,, e),...„,.... 4
me of Seller
Date signed (mm/dd/yyyy) Printed Name of Seller p Date signed (mm/dd/yyyy)
Dwight"Matt" Smith, Member 9/21/2022
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT AP
( Buyer 2- Name as it appears on ct -4n e docLiKerit.
Buyer 1 — Name as it appears on conveyance document Y 320�2
Jessica A- Smith Kenneth W. Gonzales
Address (number and street) Address (number and street)
407 W. Elm St. 407 W. Elm St. Gies
City, State and ZIP Code City, State and ZIP Code OH COU 4,y
Haubstadt. IN 47639 q-,'Y
Haubstadt, IN 47639 o5Ti•
Country
ountry
United States of America United States of America
YES NO CONDITION YES NO CONDITION
p 0 1. Will this property be the buyer's primary residence? 0
0 4. Solar Energy Heating or Cooling System
0 0 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device
this residence? If yes, provide address: 0 p 6. Hydroelectric Power Device
Address (number and street) ❑ L 7. Geothermal Energy Heating or Cooling Device
City, State, ZIP code, and county
a —f — o-7 - Lto((- cco( . 3,. 5-_ ems'
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Page 3 COPY
SALES DISCLOSURE FORM SDF ID I 1 2022 1 I
County Year Unique ID
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B. CONDITIONS -Check only those that apply.
YES NO CONDITION
Page 1 COPY