Homestead_Massey (4) H. PREPARER
Preparer of the Sales Disclosure Form Title
Megan Boger 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
The Bettye Montgomery Revocable Trust dated the 20th day of May,2021
Address(number and street) Address(number and street)
JO11'4 .S S 5 Vv
City,state,and ZIP Code City,state,and ZIP Code
U 00e h CO t 1-e I h 1-4M‘,5
Country Country
US US
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.
Signature of Seller _ Signature of Seller
Printed Name of Seller/ D, a signed(mn/�dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Bettye Montgomery Trustee /08/2023 t
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—t lTl LL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appea on n yan ment
Mitchell Massey
Address(number and street) Address(number and street),],,
304 Shelby Street t /V 09
City,state,and ZIP Code City,state,and ZIP de zaea
Vincennes, IN 47591 G/8sQ�� r`C .
Country Country OUNT
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 O 0 3.Homestead
Cl O residence? 0 0 4.Solar Energy Heating or Cooling System
d2.Does the buyer have a homestead to be vacated O C] 5.Wind Power Device
O for this residence? If yes,provide address: O lJ 6.Hydroelectric Power Device
Address(number and street) 0 C] 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county Q Q�
- 1 - -1d{y 103- 00(. 2t09- c3t} ,
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Last 5 of SSN:
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