Homestead_Mason H. PREPARER
Preparer of the Sales Disclosure Form I 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
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
I HOWARD H. HARRIS DARLENE M. HARRIS
Address(number and street) Address(number and street)
6965 S State Road 57 6965 S State Road 57
City,State,and ZIP Code City,State,and ZIP Code
Mackey, IN 47654 Mackey, IN 47654
Country Country 1
E-mail Address
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 Signature of Seller
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
HOWARD H.HARRIS May 3, 2024 DARLENE M. HARRIS May 3, 2024
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY L THAT APPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on con ument
SABRINA JO MASON !!
Address(number and street) Address(number and street)
6965 S State Road 57
City,State,and ZIP Code City,State,and ZIP Code 4Y >
Mackey, IN 47654 2
Country . Country
_ G/eS
E-mail Address
to apply for certain deductions.Identify all of tFtifSt apply:
YES NO CONDITION YES NO CONDITION
27 ❑ 1.Will this property be the buyer's primary Er ❑ 3. Homestead
residence? ❑ 121 4.Solar Energy Heating or Cooling System
Ei 2. Does the buyer have a homestead to be vacated ❑ Q- 5.Wind Power Device
1-1 for this residence? If yes, provide address: ❑ a 6. Hydroelectric Power Device
Address(number and street) ❑ (-Er 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County _6 - - I5 - Lt - ouO.0 4- L--VLi2- .
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
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