Homestead_Heuring 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 conveyance document
Estate of Thomas G.Shearer
Address(number and street) Address(number and street)
764 King Fredrick Lane Southwest
City,State,and ZIP Code City,State,and ZIP Code
Concord, NC 28027
Country Country
E-mail Address
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.
Signature of Seller Signature of Seller
X•k" VDU'e
Printed Name of Seller ` Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Doreen F.Wilder,Personal Represerltativ October 11,2024 October 11, 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' -...ears on conveyance document
Casey Lee Heuring h
Address(number and street) Address(number-rid st t) 1
1887 N State Road 65 _ A '
City,State,and ZIP Code City,State,and ZIP Code ' -
Princeton, IN 47670-8502 Oct ,
Country Country 7 2024
E-maii Address
may be used to apply for certain de& d ld p of those that apply:
YES /NO CONDITION YES NO CONDITION LibiroR
- J 1.Will this property be the buyer's primary [t2( In 3.Homestead
❑ residence? El Er` 4.Solar Energy Heating or Cooling System
❑ r—r2.Does the buyer have a homestead to be vacated 0 [r 5.Wind Power Device
for this residence?If yes,provide address: ❑ Lid 6.Hydroelectric Power Device
Address(number and street) ❑ D- r.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
‘ () —O -31- WO— g--O2- .-
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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