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HomeMy WebLinkAboutHomestead_PimentelH. PREPARER Preparer of the Sales Disclosure Form Title Leah Brown Settlement Arlent Company Email Address Telephone Number Re ional Title Services LLC closings@regionaltitlellc.com ( 812 ) 759-5555 Address (number and street, city, state, country, and ZIP Code) 7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715 1. SELLER(S)/GRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as appears on n F document Rachel L. Metz Address (number and street) Address (number and street) 2639 W Julie Drive City, State, and ZIP Code City, State, and ZIP Code JUL U ® c Princeton, IN 47670 Country Country US Email Address Telephone Number Email Address GIB SON pone Number rachelmtz0l@gmail.com ( 812 ) 630-2188 COUNTY Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct, d 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. Signs r�r Signature of Seller Printed Name of Seller Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy) Rachel L. Metz 06/26/2026 06/26/2026 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 Casey R. Pimentel Address (number and street) Address (number and street) 850 Madison Street City, State, and ZIP Code City, State, and ZIP Code Bridgeport, IL 62417 Country Country US Email Address Telephone Number Email Address Telephone Number casey_pimp2011@yahoo.com I ( 618 ) 912-2266 ( ) 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 ® O 1. Will this property be the buyer's primary ® O 3. Homestead O ® 4. Solar Energy Heating or Cooling System O ® 5. Wind Power Device jresidence? 2. Does the buyer have a homestead to be vacated R 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) a)(9 _ 11 _ 1 5 _ 1 c, _ oo ---� . T7 � — co - 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 6-1.1-5.5. 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/Drfver's License/ID/Other Number is necessary only if a Homestead Deduction is being Fled.) Si nature of B yer 1 Signature of Buyer 2/Spouse ©c -aC- Print6d Legal Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) ' Casey R. Pimentel 6/26/2026 06/26/2026 Last 5 Digits of Buyer 1 SS Dri er Li -nse/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number Page 3