HomeMy WebLinkAboutHomestead_Simpson III H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail 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
Kyle Grant Alyson Grant
Address (number and street) Address (number and street)
106 E Oak St 106 E Oak 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.
i ature of SellerA.,_/ yature of Seller
* ,
tinted Name of S let Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Kyle Grant 12/5/2025 Alyson Grant 12/5/2025
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
Ricky N. Simpson Ill
Address (number and street) Address (number and streFILED
106 E Oak St
City, State and ZIP Code City. State and ZIP Code
Fort Branch, IN 47648 DFC 0 8 225 _
Country Country ,/
United States of America ' �"' / - -- i -l2OO . ; �¢e21,76
apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YE NO CONDITION
❑ 1. Will this property be the buyer's primary residence? ❑ 3. Homestead
C acii 2. Does the buyer have a homestead to be vacated for this I El 4. Solar Energy Heating or Cooling System A
residence'? If yes, provide address: ❑ Z 5. Wind Power Device
Address (number and street) ❑ Q 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heatirg or Cooling Device :k
I
City. State, and ZIP Code County , I
/ , q D0- - �; DL)i; -1ci --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 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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