Homestead_Beadle H. PREPARER
Preparer of the Sales Disclosure Form Title
Jamie E. Smith Escrow Officer
Company
Address(number and street, city, state, country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on c y c ocument
RANDY G. BAILEY
Address(number and street) Address number and street
1018 Taft Town Road ( ) tr-
City,State,and ZIP Code City,State,and ZIP Code -144
Princeton, IN 47670-8603 6 2O2y
Country Country 03)
G/ES
G4Q K.,_
E-mail Address
best of my knowledge and belief,is true,corrrct 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.
Signatyre of Sel r s� L�� Signature of Seller
yn(
c';,--c-c';,--c- - ✓
ted Name Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
RANDY G BAILEY January 22, 2024 January 22, 2024
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 appears on conveyance document
CURTIS W. BEADLE SHEILA K. BEADLE _
Address(number and street) Address(number and street)
1018 Taft Town Road 1018 Taft Town Road
City,State,and ZIP Code City,State,and ZIP Code
Princeton, IN 47670-8603 Princeton, IN 47670-8603
(>0 Country Country
N
E-mail Address
YES NO CONDITION YES l NO❑ CONDITION
1.Will this property be the buyer's primary "t Ef' 3. Homestead
O L ❑ residence? 4. Solar EnergyHeatingor❑ � Cooling System
2. Does the buyer have a homestead to be vacated ❑ V 5.Wind Power Device
L for this residence? If yes, provide address: ❑ Z 6. Hydroelectric Power Device
I
N, AdriniuTiber,aind,trreeet)�4 El gr 7. Geothermal Energy Heating or Cooling Device
O LL 1 t JK1-/�
City State, cod
e,
ZIP e,an ounty
VP-ie,cod NC C q --/ (0-10 ah-iZ -oc-L,Do -eoz Igo- 02
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
.JC 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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