Homestead_Stephens (2) 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 l Seller 2—Name as appears on conveyance document
Nicholas Tyler Edwards
Address(number and street) Address(number and street)
605 S Center Street
City,State,and ZIP Code City,State,and ZIP Code
Fort Branch, IN 47648-1701
Country Country
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.
Signature of Seller y Signature of Seller
T , `,. .rinted Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller _ Date Signed(mm/dd/yyyy)
Nicholas Tyler Edwards January 15,2025 January 15,2025
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 it appears on conveyance document
Jacqueline Marie Stephens
Address(number and street) Address(number and street) ______.4,k____ .
605 S Center Street _
City,State,and ZIP Code City,State,and ZIP Code
Fort Branch, IN 47648-1701
Country Country J4 u N ' 1)
E-mail Address
04r 102,5.
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.''%,;(1,-r I •f those that apply:
YES NO CONDITION YES NO CONDITION Co CP
1.Will this property be the buyer's primary E] 3.Homestead tiT),
❑ residence? Z.
❑ 127-4.Solar Energy Heating or C6�tem
�.Does the buyer have a homestead to be vacated 0 �5.Wind Power Device R
❑ for this residence? If yes,provide address: ❑ 6.Hydroelectric Power Device
Address(number and street) • ❑ 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
�-ta-19 -101.-000 39.$ -®26 .
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
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