Homestead_Heldt (6) H. PREPARER
--- -i■ ---
Preparer of the Sales Disclosure Form Title
Bryce Courtney Title Company
Company
Address (number and street, city, state, country, and ZIP Code)
I
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as itappears on conveyance document Seller 2 - Name as appears on conveyance .A '
Cynthia J. Bush _
r Address (number and street) Address (number and street)
1190 E Taftown Road -4A
City, State, and ZIP Code City, State, and ZIP Code S5�O
Princeton, IN 47670 <7
Country 1 Country oz.,
?as
US I S
best of my knowledge and belief, is true, co •mplete as
required by law, and is prepared In accordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the v= e4 .f transferred
real property, or om is or falsifies any Information required to be provided, commits a Level 5 felony. -- ___
Sims lure 5dpeiter k S,gnalue of Seller
(41tVa - . . .
Prini€d Nam el - Date Signed (mm/dd/yyyy) Punted Name of Seller Date Signed (mrn/dd/yyyy)
Cynthia J. Bush 09/18/2025 09/18/2025
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
Steven Heldt Kimberly Heldt ,
Address (number ands et) Q Address (number and street)
5 0 t 0
ply, State, and ZIP Codes y, State, and ZIP Code •.
• Li 'l lc ) 19 & t "Franc sc 7 1 .
Country l Country
US US
Email Address
YES NO CONDITION YES NO CONDITION
' Nt- n 1. Will this property be the buyer's primaryN4:1- 0 3. Homestead
residence?
O ® 4. Sotar Energy Heating or Cooling System
O LE for
Does the buyer have a homestead to be vacated 0 ® 5. Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address (number and street) 0 M 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County Z*.)-12- 'O --- -L 0Q - 001 AC C - 02,4_ .
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete
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