Homestead_Dilbeck (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 conveya cum nt
Theresa M. McCarty John W. McCarty II
Address(number and street) Address(number and street) `/ '1)
Gl
300 McCreary Rd.,#3313 300 McCreary Rd.,#3313 <2,
City, State and Wylie,TX 75098 1P Code City, State and Wylie,TX 750981P Code G'jbs0,(, <''jj�S
Country Country COL
United States of America United States of America
Email Address Telephone Number Email Address one Number
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.
Signatu f Seller�{�vt0 . pQ" Signature of S,e�t_e 0(, 5 pa„ p
Printed Name of Seller Date Signed (mm/dd/ Printed Name off Seller Datee'Signed(mm/dd/yyyy)
Theresa M. McCarty YYYY) John W. McCarty 11 7/23/2025
7/23/2025
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
Helen Dilbeck
Address(number and street) Address(number and street)
11492 S 150 W
City,State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639
Country Country
United States of America
Email Address Address Telephone Number
y 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:
0 YES NO CONDITION YES NO CONDITION (.t
SEl 1. Will this property be the buyer's primary residence? IZI 0 3. Homestead
El 0 2. Does the buyer have a homestead to be vacated for ❑ El 4. Solar Energy Heating or Cooling System
Dthis residence? If yes, provide address: 0 Q 5. Wind Power Device
Address(number and street) 0 El 6. Hydroelectric Power Device
11492 S 150 W 0 E 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
t
Haubstadt, IN 47639 Gibson —23"O -- 2o0- o00-=#' —oo9 •
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
LN License/ID/Other Number is necessary if a Homestead Deduction is being filed.)