Homestead_Watt H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company E-mail address Telephone number
Southwestern Indiana Land Title christa@swinland.com (812)425-0055
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 convey ce document
Johsa A. Smith '7,
Address(number and street) Address (number and street)
1345 W.Wheatland Ct. ..4 .:.�
de
City, State and ZIP Code City, State and ZIP Code 'Pe2
Haubstadt, IN 47639 .9
Country Country ®�� 40 • IQ?Z (--
United States of America V�
E-mail address Telephone number E-mail address ��( _ephone number
`{j I :: I sU 4,.n
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief, is true,correcCvalue
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 va ue of transferred
real prope or onjjts or f s y information required to be provided,commits a Level 5 felony.
of S Signature of Seller
Cr_it of Seller Date signed(mm/dd/yyyy) Printed Name of Seller 1 Date signed(mm/dd/yyyy)
J aA. Smith II--(Li - tea-
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Summer A.Watt Jason Joe Watt
Address(number and street) Address(number and street)
317 Hawthorne Dr. 317 Hawthorne Dr.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
United States of America United States of America
E-mail address Telephone number E-mail address Telephone number
SummerAWatt@gmail.coom (812)677-0504 Jason@dartbrokers.com (630)618-1649
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
El ❑ , . Will this property be the buyer's primary residence? El ❑ 3. Homestead
�// El El 4. Solar Energy Heating or Cooling System
0 2. Does the buyer have a homestead to be vacated for ❑ p 5. Wind Power Device
this residence? If yes, provide address: 0 El 6. Hydroelectric Power Device
Address(number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code, and county
�(; -1.2- Apo -00-2 . 3/� - 0 a
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and e
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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spo
information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
Signs ure of Buyer 1 0 aka" S ature0 of t/Spouse
Printed Legal Name of Buyer 1 Sign Date(MM/DD/YY) Pr t Legal Name of Buyer 2/Spouse Sign Date(MM/D )
Summer A.Watt I I - )-I -a-a- Jas oe Watt . f!-1 y-
Last 5 Digits of Buyer 1SN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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