HomeMy WebLinkAboutHomestead_SmithH. PREPARER ~ ^
Preparer of the Sales Disclosure Form Title
Kelly E Norton Settlement A ent
Company Email Address Telephone Number
Bosse Title Comoanv ( 812 ) 421-4000
Address (number and street, city, state, country, and ZIP Code) _.
4799 Rosebud Lane, Newburgh, IN 47630
1. SELLER(S)IGRANTOR(S)
Seller 1 - Name as it appears on conveyance document
Seller 2 - Name as appears on e'y ocu
�Ij
Troy D. Perkins
Address (number and street)
Address (number and street)
6114 S. 175 E.
_JUL__-2 8
City, State, and ZIP Code
City, State, and ZIP Code
Fort Branch, IN 47648
Country — - —
C
Country --
us
GIBS
Email Address Telephone Number Email Address I'e19MW9CNVmber
giboncountydiesel@outlook.com ( 812 ) 604-7404 ( )
Under penalties of perjury, 1 hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete as
require"y 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 pr rty( 0 omits or falsifies any Information required to be provided, commits a Level 5 felony.
Signafltr of,%ller ....•-- - Signature of Seller
ririted ame of Seller
Date Signed (mm/dd/yyyy)
Printed Name of Seller Date Signed (mm/dd/yyyy)
Troy D. Perkins
07/27/2026
I 07/27/2026
J. BUYER(S)IGRANTEE(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
Nathanael Smith
Danielle R. Smith
Address (number and street)
Address (number and street)
612 Kessel Rd.
612 Kessel Rd.
City, State, and ZIP Code
City, State, and ZIP Code
Ave, IL 62907
Ava, IL 62907
Country _
Country
US
US
Email Address
Telephone Number
Email Address
Telephone Number
( 618 ) 521-2111
(1�l8 )502/- RV
Pursuant to IC 6-1.1-12.44, the Sates 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
(5O 3. Homestead
residence?
Q ® 4. Solar Energy Heating or Cooling System
i O ® 5. Wind Power Device
D 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
O ® 6. Hydroelectric Power Device
O (Z 7. Geothermal Energy Heating or Cooling Device
Address (number and street).,
_ 1C� (�_ 3� - OM , O75 -C)(45
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, SSWDriver's LicenseRDlOther Number is necessary only if a omestead Deduction is 4irrued.)
Signature of Buyer 1
S nature of B. 'r 2/Spoe t,
Panted Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Pr -Ned Pr—NedLegal Name of E erti2/ ' use Sign Date (MM/DD/YY)
Nathanael Smith _ 7/27/2026
Danielle R. Smith 07/27/2026
Last 5 Djgit of Buyer 1 SSN/D 'ver s License/l
her ber
_
Last 5 Digits of Buyer 2/Spou a SN/Driver s License/)D 0 er Number
Page 3