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Homestead_Smith (3)
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 Jebadiah R. Mayles Address(number and street) Address(number and street) 212 E 3rd St. City,State and ZIP Code City, State and ZIP Code Hazleton, IN 47640 , Country Country s" United States of America iC 1:4 Email Address Telephone Number Email Addressephone Number 4 r Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge elief,is tri e f.2oJ rect,an. • * •te as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentio Isifies the vall'ie of transfe -_:• eal property,or omits or falsifies any information required to be provided,commits a Level 5 felony. S'p '� Signature of Seller Signature of Seller - �'OPrinted Name of Seller ?rat/Pais Date Silted /dd/ Printed Name of Seller 44L Date Signed(mm/dd/yyyy) Jebadiah R. Mayles yyyy) Q�TO 4/30/2025 9 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 Basil R. Smith Address(number and street) Address (number and street) 4803 15th St E City, State and ZIP Code City, State and ZIP Code Bradenton, IN 34203 Country Country United States of America Email Address NO CONDITION �' K v ❑ 1. Will this property be the buyers primary residence? El 3. Homestead 0 ,fi,( 0 �2. Does the buyer have a homestead to be vacated for 0 El 4. Solar Energy Heating or Coo' g'"y t Y;,.. 0 © 5. Wind Power Device . this residence? If yes,provide address: �'' Address(number and street) 0 RI6. Hydroelectric Power Device 0 El 7. Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County 2C-0 2- Sti - d2---0 coo .'2 �q --019 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