Homestead_KIeffer Jr •
H. PREPARER ______ _—
Preparer of the Sales Disclosure Form Title .
Leah Brown Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715 ..... . —
I SELLER(S)/GRANTOR(S)
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Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance•oc m-n
William M.Hurt Charlotte M.Hurt
Address(number and street) Address(number and street) JUN 0 4 2025
1514 Willowbrook Drive 1514 Willowbrook Drive
City,State,and ZIP Code City,State,and ZIP Code
Princeton,IN 47670 Princeton,IN 47670 Ac.kze,e a fikie•&241)
Country Country
US US GIBSON COUNTY AUDITOR
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 Inf. atlon required to be provided,commits a Level 5 felony.
Siwt..turpf--,t r . •t nature of Seiler
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Printed Name of Seller Date Signed(mm/dd/yyyy) ' nted Name of Seller Date Signed(mm/dd/yyyy)
William M.Hurt 05/28/2025 Charlotte M.Hurt 05/28/2025
_. .
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
William Kieffer.Jr. ' Ruth Stuessel
' Address(number and street) Address(number and street)
1514 Willowbrook Dive 1514 Willowbrook Drive
City,State,and ZIP Code City,State,and ZIP Code
Princeton,IN 47670 Princeton,IN 47670
Country Country
US US
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YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary IIJ 0 3.Homestead
(Xi 0 residence? 0 Cit) 4,Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 12 5.Wind Power Device
0 igi for this residence?If yes,provide address: 0 fi 6.Hydroelectric Power Device
Address(number and street) E) Ot 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County 2_6-12_- 0 G- 402 —Go -1 . 4.
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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