Homestead_Luigs (2) H. PREPARER
Preparer of the Sales DisclosurS Form Title
Payge Marx Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Lana S. Schmitt
Address(number a street) Address(number and street)
�S�`� - �pj L,- •
City,state,and ZIP Code . City,state,and ZIP Code
,hS 4- Z vJ `f'7t 3 `1
Cou ry Country
US US
the best of my knowledge and belief,is true,'correct and complete as
required by law,and is prepared in accordance with IC 6-.11�-5.5 perso,A who knowingly and intentionally falsifies the value of transferred
real property,or o is fa ifies any inform i equv `o �/roviaed.,commits a Level 5 felony.
rat f S Iler /U�I�/ � 71/f et T /Signature of Seller
Pri ted ame Seller / Date signed(mm/d./ yyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Lana S. Schmitt 11/22/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL T •T APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on con a c-Iiii ent
Gloria A. Luigs
Addr s(number and treet) A 1 i.. yi lIV
''nn Address(numberandt) Y
City,st te,a d ZIP Code City,state,and ZIP Code o`
�jL 5+ &J �✓v `7(a3 %
Country
Country C t l .001 OR
us US �'�
used to apply for certain deductions.Identify all of those that apply:
• YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary
p 0 3. Homestead
C? residence?residence? O Cl 4. Solar Energy Heating or Cooling System
_mjO 2. Does the buyer have a homestead to be vacated 0 C) 5.Wind Power Device
O for this residence? If yes,provide address:Cv 0 O 6. Hydroelectric Power Device
O Addrp (`umber V street)' 5 l O C) 7.Geothermal Energy Heating or Cooling Device
91 it?
c.
City,state.ZIP code,and unty _ 9 G,'31 DL2 —a _Q ^ — a co _-000•F's—coci
M Under pehal ies of perjury,I hereby certify that this Sales Disclosure,to thei best of my knowledge and belief,is true,correct and complete`+ ►'
k 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
btransferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
l
Last 5 of SSN: 1
Page 3 of 5
C 0 p'yoreman412 WatsonEagleCrest LandBlvd Title. LLC
7
Evansville, IN 47715