HomeMy WebLinkAboutHomestead_Bailey (3)H. PREPARER
Preparer of the Sales Disclosure Form
Title
Jamie E. Smith
Escrow Officer
Company
True Title Service, LLC
E-mail Address
jamie@truetitiein.com
Telephone Number
(812) 453-2559
Address (number and street, city, state, country, and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLER(8)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Matthew Scott Stout
Erika Mae Stout
Address (number and street)
Address (number and street)
1903 South Boulevard Place
1903 South Boulevard Place
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Princeton, IN 47670
Country
Country
E-mail Address
el hone Number
E-mail Address
Telephone Number
m.stout8435@yahoo.com
—
emadamsl992@gmail.com
(930) 215-5245
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.
Signatu f Seller
Signature 9f Seller
��7
Printed Name of geller
Date Signed (mm/dd/yyyy)'Printed
Name of Seller
Date Signed (mm/dd/yyyy)
Matthew Scott Stout
July 13, 2026
Erika Mae Stout
July 13, 2026
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFMIOTtAT APPLY
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it appears on oo a um 4
Randy G. Bailey
Address (number and street)
Address (number and street)
1903 South Boulevard Place
gill
City, State, and ZIP Code
City, State, and ZIP Code JUL
Princeton, IN 47670
Country
Country
E-mail Address
Telephone Number
E-mail Address ON C �v
m r
rhbailey7l@gmail.com
812 457-9177
'QOD/-ro
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 O CONDITION
YES NO CONDITION
❑ 3. Homestead
❑1. Will this property be the buyer's primary
'
re nce?
❑ [�4. Solar Energy Heating or Cooling System
5. Wind Power Device
® 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address;
® 6. Hydroelectric Power Device
® [,� 7. Geothermal Energy Heating or Cooling Device
) _ l Z T ao'l —oz)('9' } ao — C-0Z
Address (number and street)
City, State, ZIP code, and 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 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/Drivees Licens&=Otir@r Number /s necessary only /f a Homestead Deduction is being flied.)
itin o BuY 1
Signature ofBuyer vSpouse
Printed Legal Odmaaf Buyer 1 Sign Date (MAA/DD/Y)r)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Randy G. Bailey July 13, 2026
July 13, 2026
Last 5 Digits of Buyer 1 SSN/ riv r icense/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's LicenseAD/Other Number
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