Homestead_Smith (29) H. PREPARER
—-
Preparer of the Sales Disclosure Form Title
Stacey Salzman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
2301 N.Burkhardt Road,Evansville, IN 47715
I. SELLER(S)IGRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveye document
Collen J.Schenk It'
Address(number and street) Address(number and street)
8874 S.Meadow Ln.City,State,and ZIP Code City,State,and ZIP CodeA
Owensville,IN 47665 4/0/pi
Country Country /6'
US G'/� �eph
04
person who knowingly and Intentionally fal value of transferred
real property,or omits or falsifies a nformation;required to be provided,commits a Level 5 felony. QQ -
i nature Seller Signature of Seller
Printe Name Date Signed
at S g ed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Collen J.Schenk 04/12/2024 04/12/2024
J;_,BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY,TAX.DEDU,CTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Damian M.Smith
Address(number and street) Address(number and street)
7369 S. 1225 W
City,State,and ZIP Code City,State,and ZIP Code •
Owensville, IN 47665
Country Country
US
Email Address
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
® 1.Will this property be the buyer's primary ® 0 3. Homestead
residence? 0 3 4.Solar Energy Heating or Cooling System
0 ® 2. Does the buyer have a homestead to be vacated
0 ® 5.Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address(number and street) 0 IX 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
o( ,-
1 _ ?A-moo -004 y30 - it
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete