Homestead_Smith (89) I
H. PREPAREIR . .
Preparer of the Sales Disclosure Form Title •
Christa D.Tr4ey Escrow Officer
Company 1 •
Address(num8er 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)ORANTOR(S) I
1
Seller 1-Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
1
i
Jason A.Engelbrecht Carrie A. Engelbrecht
FIL
Address(numHer and street) Address(number and street) 1 JD
1036 N Main Si
1036 N Main St
City,State and ZIP Code
City,State and ZIP Code
Princeton, IN 47670
Princeton, IN 47670 JUL 2 f
Country
Country 025 4,14(3 United States of America
United States of America
•
.4.iall Addr
l
ess&/ /
law,and is prepared in accorda e with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferired real property,or
omits or falsifie !any i rma lo quIred to be provided,commits a Level 5 felony.
/gip ure o I r
Signature of Seller
I./
P d Na of r
id
Date Signed(mm/dd/ Printed Name ofSeller
-)Af,e17
Date Signed(mrn/dd/yyyy)
Js A.Engelbrecht YYYY) ---- Carrie A. Engelbrecht
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY 1
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Ashley Smith
Brian Nowlen
Address(number and street)
Q K
Address(number and street)
‘ -k-cActiv- U I/-
City,State and ZIP Code
City,State and ZIP Code I
,IN %1‘ 't,If‘P-% JZS -2,--3 Lk--11, / , IN V;VI t.t..fro- ''' ,N‘ itiCi j
Country
1 Country
United States of 4kmerica
United States of America
Email Address
YES NO CONDITION
YES NO CONDITION
. ,
Er a ,,,1• Will this property be the buyer's primary residence? Mee- E3. Homestead 4,0%
11.6 ,4.,
., , •,., ,.,.%,
0 0/.'2. Does the buyer have a homestead to be vacated for 0 5/.4. Solar Energy Heating or C.• i 0. ,L•glo.:. .1.
,z,,,,,-,
this iesidence? If yes,provide address: 0 Wind 5. Power Device ,,,, -.4.•
Address(number.end street) 0 la,.-6. Hydroelectric Power Device ;
• 1 0 0 7. Geothermal Energy Heating or COoling Device
1
City,State,and ZIP Code County
—06i,e:// .3 I-0.2_8'
Under penalties of Perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,andlcomplete as