HomeMy WebLinkAboutHomestead_Brugger H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Lisa Mathies
Address(number and street) Address (number and street)
1474 N Old Us Hwy 41
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670
Country Country
United States of America
Email Address
Under penalties of perjury, I hereby certify 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.
t re of S Io/6 Signature of Seller
int d Name of Selfar Date Signed (mm/dd/ Printed Name of Seller p e Signed (mm/dd/yyyy)
Lisa Mathies YYYY)5/
5/200
/2024
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THATAPPLY I)
Buyer 1 -Name as it appears on conveyance document Buyer 2- Name as it appears on convWar2wdokument
Rodney M. Brugger Vanessa K. Lowe v 4624
Address (number and street) Address (number and streOeS
1114 Greenview Ave. 1114 Greenview Ave. ONC
City, State and ZIP Code City, State and ZIP Code O Q
Y _N7q
Mount Carmel, IL 62863 Mount Carmel, IL 62863 �fTOR
Country Country
United States of America United States of America
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION ...1051
O ❑ 1. Will this property be the buyer's primary residence? 2 0 3. Homestead
0 2 4. Solar Energy Heating or Cooli
2. Does the bu er have a homestead to be vacated for in Power Device ' " ,
0 Y ❑ 5. W d
this residence? If yes, provide address: 0 p 6. Hydroelectric Power Device
Address(number and street) 0 El 7. Geothermal Energy Heating or Cooling Devi(k
City, State, and ZIP Code County )C-11-01 -100 - 0 03 126_ 02-3- .
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