HomeMy WebLinkAboutHomestead_Schmitt (13) 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
Heather A. Burton ,r
Adcr..ess(number and s 1 0 Address(number and street)
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Citate�and ZIP�o�� jV 4)(�� City,state,and ZIP Code 'y(Zv 03
Country (v� Country ,. q/z3
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Under penal s f perjury,I herebycertifythis Sales Disclosure,to the best of my knowledge and belief,is�gi�� t and complete as
P P s re i^leV� f
required by aw,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsi �he value of transferred
rea prop rty,or omits or falsifies any information required to be provided,commits a Level 5 felony.
S at f Se er ^ Signature of Seller
rinted e of eller C� Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Heather A. Burton 07/31/2023
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary O 0 3. Homestead
O O residence? O Q 4. Solar Energy Heating or Cooling System
O 2. Does the buyer have a homestead to be vacated O O 5.Wind Power Device
for this residence?If yes, provide address: O p 6. Hydroelectric Power Device
Address(number and street) 0 Q 7. Geothermal Energy Heating or Cooling Device
11 CJ1. I ir-e-144"- a,h_ a e .
(---- City,stat IP cod , d county , 6-1�_ lCf_103 ` 000. 1 8 — o2
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CZ Under penalties of perjury,I hereby certify that 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.(Note:Both spouse's
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