HomeMy WebLinkAboutHomestead_Davis (3)5PREPARER�$�afes Di ure Form
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Title
Title Com an
Email Address Telephone Number
( 812) 759-5555
Regional Title Services LLC
closings@regionaltitlelic.com
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
John Davis
Debra Davis
Address (number and street)
Address (number and street)
717 E State Street
717 E Skate Street
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Princeton, IN 47670
Country
Country
us
u5
Email Address Telephone Number
Email Address Telephone Number
( )
(QNZ)
Under penalties of pe ' greby certify this Sales Disclosure, to the best of my knowied elie' , is true, correct, and complete as
who knowin infentiort Ily falsifies the value of transferred
IC 6-1.1-5.5. A t
required bylaw a prep t'ed in accordance with person
its or sifies any information required to be provided, commi 5 felony.
real property
Signature r
Signature
f
P . d Nam a ler Date Signed (mm/dd/yyyy)
P ' e e Iler� ate Signed (mm/dd/yyyy)
John Davis 06/05/2026
D, 06/05l2026
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL TH LY
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it appears on conveyance u e
Logan D. Davis
Kheeli P. Davis
Address (number and street)
Address (number and street)
St
717 E. State St
717 E. State .1
IF
City, State, and ZIP Code
V
City, State, and ZIP Code 1 2�
Princeton, IN 47670
Princeton, IN 47670 r!
Country
Country Qz
alb
us
Email Address Telephone Number
us
Email Address %Ae(WOOmer
logan_davis88@hotmail.com ( 812 ) 664 5601
)�Ci�3� '
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
® O 3. Homestead
® O residence?
O ® 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated
O ® 5. Wind Power Device
O ® for this residence? If yes, provide address:
O ® 6. Hydroelectric Power Device
Address (number and street)
O ® 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
a(9 _ la-Q� -
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 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 t icenseltD/Other Number is necessary only if'a Homestead Deduction is being tiled.}
Buy
Sig at re of B yer 5pause `r
V
U
Name of Buyer 1 Sign Date (MMIDDIYY)
K5Digits
Printed Legal ame of Buyer 2/Spouse Sign Date (MM/DDNY)
is 6/5/2026
Kheeli P. Davis 06/05/2026
of Buyer 1 $SNId� er' License/ID/Other Number
I Last 5 Digits of Buyer 2/Spau SBNIQriver's LicensellD/Other Number
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