Homestead_Kays H. PREPARER •
Preparer of the Sales Disclosure Form Title
Katie Johnson Licensed Escrow Officer
Company
Address(number and street, city,state, country,and ZIP Code) _ �-
401 Church Street, #1710, Nashville, TN 37219
I. SELLER(S)IGRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Renee Sheren
Address(number and street) Address(number and st t)
l , .
2413 North County Road 775 West < k. _
City,State,and ZIP Code City,State,and ZIP Code ..
Petersburg, IN 47567 -IA Ar
Country USA
Country rY 3 2025
G' SON CO
.-Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and bel ititici
ect and complete as
required by law,and is prepared in accordance with_IC 6-1.1-5.5.A person who knowingly and intentionally faT f(ethe value of transferred
;real pro. ,or omits or falsifies an information required to be provided,commits a Level 5 felony.
Si ur f Seller 4. --
4-P-7-2Signature of Seller
P nted Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller I Date Signed(mm/ddlyyyy)
Renee Sheren December 20, 2024 'December 20, 2024
,.:1':.,BU.YER(S.)/GRANTEE(S) -APPLICATI.ON FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Jayden Kays Jessica Kays
Address(number and street) Address(number and street) ff. ;,
213 West Mulberry Street 213 West Mulberry Street �,.. i�" u ...
City,State,and ZIP Code City,State,and ZIP Code '' r t' 1;.
Princeton, IN 47670 Princeton, IN 47670 ''
Country us„ Country USA
Pursuant to IC 6-1.1-12-44,the Safes Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION I YES NO CONDITION
1.Will this property be the buyer's primary 12 ❑ 3. Homestead
x I residence? ❑ ® 4. Solar Energy Heating or Cooling System
--1 2. Does the buyer have a homestead to be vacated El11 5. Wind Power Device
X for this residence? If yes, provide address:
❑ ❑x 6. Hydroelectric Power Device
Address(number and street) ❑ ® 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
C6.1L- 07-3O4-o00 , 21 - 02-8 .
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
information, SSN/Driver's License/ID/Other Number is necessary only if a Homestead Deduction Is being filed.)
Pape 3
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