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HomeMy WebLinkAboutHomestead_Simms H. PREPARER Preparer of the Sales Disclosure Form Tele Sarah McDaniells Escrow Officer Company Address (number and street, city, state, country, and ZIP Code) 7412 Eagle Crest Blvd Evansville, IN 47715 I. SELLERS)/GRANTOR(S) _ Seller 1 - Name as it appears on conveyance document Seiler 2 -Name as e rs c eyance document LaDonna Dcug'as , Address (number end street) Address (number and street) 516 S Ninth Ave - 4?) �y + City, state, and ZIP Code City, state and ZIP!-a Haubstadt, IN 47639 C')Ip Country Count'/eS us -us °4' best of my knowledge and 'rue, correct and complete as required by law, and is prepared In accordance with IC 6.1.1.5,5. A person who knowingly and intentioned' fatuities the value of transferred real property, or omits or Pais! ies any information required to be provided, commits a Level 6 felony. Si nature 5 tier Signature of Seller _601,e4f,,d- A__ r. d a o of Seiler ' Date signed (mrn/dd/yyyy) Printed Name of Seller Date signed (mm/ddlyyyy) LaDonna Douglas .\J 0B/21/2025 J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY Buyer 1 — Name as It appears on conveyance document I Buyer 2 - Name as it appears on conveyance document Beth Simms Address (number end street) Address (number and street) L205 West Locust Street City, state, and ZIP Code City, state, and ZIP Code Fort Branch, IN 47648 Country Country Us certain deductions. Identify all of those that apply: YES �NO CONDITION YES NO CONDITION 1. Will this property be the buyer's primary Q O 3. Homestead O 0residence? 0 O 4. Solar Energy Heating or Cooling System 2. Does the buyer have a homestead to be vacated 0 O 6. Wind Power Device Q for this residence? If esprovide address: yes, O p 6. Hydroelectric Power Device l Address tnumberand treat) 0 07. Geothermal Energy Heating or Cooling Device son Vit"\a ciloci tr • City, sitge, ZIP code, a d count LA °tA -00 , �9 f - 02-k 4...-- Under, C-liteilc V‘ I k_k_ 9.- --A/ ti 9 1 i S C (D r-\S_— \ — penalties of perjury, I herebycertifythat this Sales Disclosure, to the best of my knowledge and belief, la true, correct and complete P P J Y� CHPage 3 cf 5ti4: 1 -----.—.---