Homestead_Schmitt (27) H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company
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 c.•gip, ce document
Zachary Jeffrey Willis Lucy J. Willis �G
Address(number and street) Address(number and s tYJ
1682 E.Autumn Ridge 1682 E.Autumn .
City, State and ZIP Code City, State and ZIP de "1,...�
Haubstadt, IN 47639 Haubstadt, IN 4763 �(�% r'
Country Country p' 0 Ok
United States of America United States of America a,,-c,t P�
Email Address
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.
Signature of Seller A4f,,,vt,J„,-1,.., Signature
Printed Name of er Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Zachary Jeffrey Willis —1_ 'Z is,..Z�- Lucy J. Willis -7-2 t-�3
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 apRears on conveyance document
Haley Nichole Schmitt � d, Sc \ ,--,
Address(number and street) Address(number and street) (
202 Rock Rd. oZV ). «� CL C 0
City, State and ZIP Code City, State and ZIP Code
Owensville, IN 47665 0wei sJ\tie__ 1, 3 `1 7(pki `.->
Country Country
United States of America L) S Y
t
.. YES NO CONDITION YES/ NO CONDITION
NJ ❑ 1. Will this property be the buyer's primary residence? "f 0 3. Homestead
0 4. Solar Energy Heating C li Syst
q 2. Does the buyer have a homestead to be vacated for ❑ p/ 5. Wind Power Device
D this residence? If yes, provide address:
D 0 ly' 6. Hydroelectric Power Devic
•• Address(n ber sn et) cic) 0 I�7. Geothermal Energy Heating or o I g
C a VV rLJ16��..
City, State,ZIP code, and�` unty
-e.K v- �-P - �c, F1\1 0 5--" Avo- -k\_.Q-z-ao - 00 D.14- -Carl.
1 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
1 information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)