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Homestead_Smith (24)
H. PREPARER Preparer of the Sales Disclosure Form Title Milton Norman Settlement Agent Company Email Address Telephone Number Hometown title,LLC orders@hometowntitles.com ( 812 )461-6399 Address(number and street,city,state,country,and ZIP Code) 25 NW Riverside Drive,Suite 310,Evansville,IN 47708 I. SELLER(S)IGRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Ryan W.Bruner Jennifer L.Bruner Address(number and street) Address(number and street) 404 E.Vine St. 404 E.Vine St. City,Slate,and ZIP Code City,State,and ZIP Code Fort Branch,IN 47648 Fort Branch,IN 47648 Country Country US US Email Address Telephone Number Email Address Telephone Number (Bi2 ) 2oi"fo7l FBI ) P.7o7-dS/Ga. 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. Signature an'jature of Seller Signature of Se er Printed Name of Seller Date_Slgned(mm/ddlyyyy) •nted Name Seller Date Signed(mmldd/yyyy) Ryan W.Bruner / t°/ z > Jennifer L.Bri'1(ier 3 - J. BUYER(S)IGRANTEE(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 ce cument Dalton A.Smith T Address(number and street) Address(number and street) 105 S.Main St. City,State,and ZIP Code City.State,and ZIP Code Fort Branch,IN 47648 MAR 1 1 2025 Country Country US Email Address Telephone Number Email Address GIBS / :. .r. e Number ((1K )8 ,S- �°1 UE ON COUNN(gUDIT', 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 © 1.Will this property be the buyer's primary () 0 3.Homestead residence? ❑ ►" 4.Solar Energy Heating or Cooling System ❑ 2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device for this residence?if yes,provide address: 0 ® 6.Hydroelectric Power Device Address(number and street) ❑ () 7.Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County !�,-R_ < O 3_Goo. `O t - 0 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 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 flied.) Sig attuurp uyer 1 Signature of Buyer 2/Spouse lAgl j A. i`/A 7 Printed Legal Name of Buyer 1 Sign Date(MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY) Dalton A.Smith "J.S/0(i/2-S Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number SyZI Page 3