HomeMy WebLinkAboutHomestead_Smith (26) 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 conveyance document
Jeremy C. McKinley Trianna Jazette McKinley
Address (number and street) Address (number and street)
203 W Locust St. 203 W Locust St.
City, State and ZIP Code City, State and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country Country
United States of America United States of America
Email Address
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. _
ygnature of Seller s4,0A----e•-•"67- -- ----5--/--------- ign re of Seller %%������ _
Printed Name eller Date Signed (mm/dd/ c inted Name of eller e Signed (mm/dd/yyyy)
Jeremy C. McKinley YYYY) Trianna Jazette McKinley 11/17/2025
11/17/2025
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 con In cu
Debra K. Smith, as Trustee for the "Bryan P. Titzer Irrevocable Trust --,v_tsb
Agreement dated June 26, 2019"
Address (number and street Address (number and street) 0EC
PO &v( cO445
City, State and ZIP Code City. State and ZIP Code
Cyni,12Lalia,, IN 41 7d/( , . . G1880 C �,�
C untry Country O0 • hZ- -
United States of America �qUQ
Email Address
for certain deductions. Identify all of those that apply:
YE NO CONDITION YES NO CONDITION
!Will this property be the buyers primary residence? ❑ 3. Homestead
❑ 1
2. Does the buyer have a homestead to be vacated for ❑ 11 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: ❑ El 5. Wind Power Device
Address (number a(Jn street) El 0 6. Hydroelectric Power Device
^ 00 1.4)- y 45--
❑ 7. Geothermal Energy Heating or Cooling Deyi
County
. State. ndCode ZIP
Cy n hi I a ft a/ IN 17‘a
, Po sty D, - ( 5? -. ) -1-KA - o o I . 3gx -02__
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
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