Homestead_McCormick H. PREPARER
Preparer of the Sales Di losure Form
.1 1 . _
Company
I
Regional Title Services LLC
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document —
Michael A.McGill Jam!M.McGill
Address(number and street) Address(number
1603 Cottonwood Drive 1603 Cottonwood Drive
City,State,and ZIP Code City,State,and ZIP Code
Princeton,IN 47670 Princeton, r
Country Country
US
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 propert ,or mi or falsifies any i ration required to be provided,commits a Level 5 felony.
Signatu Sell r Signature of Seller 1
X : ." -,.e).6 C Cchkek C 1(4 ,
Printed N m o Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/ddlyyyy)
Michael A.McGill 03/01/2024 Jami M.McGill 03/01/2024
APPLICATION• PROPERTY r .': Ai„ ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appear • veya document
David E.McCormick
•• Address(number and slyer}}
•ZIP Code City,State,a•• P.Code
Antioch,IL.rrr G/ec - ���' (c79\-\
i
CountryCountry OT ��
COUS Q4/N �
Email Address 46• Telephone Number
rOs ( )
• ••_ •
•- . - •••, - • • • .• •• • •• • -pply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION 1
O 1.Will this property be the buyer's primary '54_ 0 3. Homestead
residence? 0 •'T` 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 5.Wind Power Device
` for this residence?if yes,provide address: p •9 6. Hydroelectric Power Device
Address(number and street) 0 `T 7.Geothermal Energy Heating or Cooling Device 1
1
I
City,State,and ZIP Code County Z c t 2.,_0 6,14 G) _00 .tot 3_ - O 2.s .--- --- '- - --- - -- - ---'- -- - - = - -'-- - - he best of my knowledge and belief,is true,correct,and complete
son who knowingly and intentionally falsifies the value of
be provided,commits a Level 5 felony.(Note:Both spouse's
Homestead Deduction is being filed.) k
.nature of Buyer 2/Spouse (��
toted Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY) i -"/
03/01/2024 •V i
st 5 Digits of Buyer 2/Spouse SSNIDriver's License/ID/Other Number
n
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