Homestead_Smith (50) H. PREPARER
Preparer of the Sales Disclosure Form Title
Courtney Pruett Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on ante document
Barbara A Nelson Living Trust
Addresss(num and street) Address(number and street)
City,State,and ZIP\�e� `y ! ? City,State,and ZIP Code O�
Count Country < , Ia
best of my knowledge and 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 intents Islfles the value of transferred
real property,or omits or falsifies any Information requiredto be provided,ded,commits a Level 5 felony. 16
Signature of Seller � Signature of Seller 9
Pr' a eali a of ler Date Sig (m dd/yyyy) Printed Name of Seller D ned mm/dd/
jZ/(J`;dd. 3 ( yyyy)
JeffreyD. Nelson, Trustee r(
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document T Buyer 2—Name as it appears on conveyance document
Matthew Jatt Smith Brandi N. Smith
Address rum str a Address(number and street)
City.S� ZIP � ��
h � / `/� City,SE a ZI Code
(40
Countryt'��' !TL Country
vr 0 1.Will this property be the buyer's primary 0 3.Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
0 2.Does the buyer have a homestead to be vacated 0 2) 5.Wind Power Device
for this residence?If yes,provide address: 0 ( 6.Hydroelectric Power Device
Address(number and street) 0 ( 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code _
County
26_0 ��--1.10 —107-001 -1-)It c —02. — .