HomeMy WebLinkAboutHomestead_Beel (3)0-
H. PREPARER
Preparer of the Sales Disclosure Form
Title
Leah B row n
Tltle•Com an
Company
Email Address
Telephone Number
Regional Title Services LLC
closings@re ionaltitlellc.com
( 812 ) 759-5555
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document
Seller 2 - Name as appears o ante document
John R. Randall
Address (number and street)
Address (number and street)
10083 W 565 S
City. State, and ZIP Code
City, State, and ZIP Code
MA V
Owensville, IN 47665
I
Country
Country
us
Email Address Telephone Number
Email Address
Number
JRandall10482@gmail.com ( 816 ) 633-2160
O
N CpUnder
6elephone
penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is tr ,� 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,
Sign ur Selle
Signature of Seller
�af
fed Name of Seller
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
John R. Randall
05/0j2026
05/08/2026
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
Zacha R. Beet
Kendra S. Hicke.
Address (number and street)
Address (number and street)
915 S Hall Street
915 S Hall Street
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Princeton, IN 47670
Country
Country
us
us
Email Address Telephone Number
Email Address
Telephone Number
Z8ee15811@gmail.com ( 812 ) 698-4904
Kendra.S.Hickey@gmail.com
( 574 ) 301-9390
Pursuantto IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those thatapply;
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyers primary
® O 3. Homestead
IN O residence?
O ® 4. Sofar Energy Heating or Cooling System
O ® 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
o ®
for this residence? If yes, provide address:
O ® 6. Hydroelectric Power Device
O ® 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
� )/ _ _ 111 ^ OC\ _ 1� 001-1 . () g - 0�
City, State, and ZIP Code County
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 6-1.1-6.5. 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 LicensafiD/Other Number is necessary only if a Homestead Deduction is being filed.)
Signature of Buyer 1
i natu pouse
Printed Legal Name of Buyer 1 Siqfn Da (M D/YY)
P 'nted Legal Name of Bu er 2/ pouse Sign Date (MM/DD/YY)
chary R. Beel 5/8/2026
Kendra S. Hic05/08/2026
key
st 5 Dlglts of Buyer 1 SSN/Driver's License/ID/Other Number
ra
Last 5 Digits of Buyer 2/S ou a SSN/Drivers License/ID/Other Number
V ,
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