Homestead_Kruse (6) H. PREPARER
Preparer of the Sales Disclosure Form Title
Claire Kincaid
Settlement Agent
I.
Company
Address (number and street, city, state, country, and ZIP Code)
4799 Rosebud Lane, Newburgh, IN 47630
__ _ _ _ _ _
I. SELLERS)/GRANTOR(S)
I
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveyance document
Kevin W. Gray _ Karen L. Wilson
Address (number and street) Address (number and street)
103 N. Jeremy Ln. 103 N. Jeremy Ln.
City, State, and ZIP Code City, State, and ZIP Code
Haubstadt, IN 47639 Haubstadt, IN 47639
Country Country -
US US
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.
Su`nature of sell, ki 'a ur f Seller
irir ed Name of Seller Dale Signed (mm/ddlyyyy) rihted ame of Seiler Date Signed (mrn/ddiyyyy)
4(evin W. Gray 11/14/2025 ' Karen L. Wilson
J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - I T Y , a • iff)
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance document
Shawn W. Kruse Jessica Kruse (y�voila:
Address (number and street) - Address (number and street)
457 E. 1200 S. 457 E. 1200 S.
City, State, and ZIP Code City, State, and ZIP Code7'
Haubstadt, IN 47639 Haubstadt, IN 47639 G1asoN �
Country Country SON G Y AUDI�
R
YES NO CONDITION YES NO CONDITION i
1. Will this property be the buyer's primary 0 3. Homestead Illik
residence? Q ® 4. Solar Energy Heating or Cooling System
- 102. Does the buyer have a homestead to be vacated 0 12 5. Wind Power Device
0 5 . for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
ITV m_ber a scree iy. 0 (R 7. Geothermal Energy Heating or Cooling Device
C 0 ft c of q ( e
State and ZtP C J County r -' )? _._ i f O - 000 6 Th----o-uf
31-010( f-,
41 (4); 0
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete I
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
inkrmation, SSN/Driver's License/ID/Other Number is necessary only it a Homestead Deduction is being filed.)
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