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HomeMy WebLinkAboutHomestead_CodyH. PREPARER Preparer of the Sales Disclosure Form Title Matthew Jarvis Escrow Officer Company E-mail address Telephone number Southwestern Indiana Land Title matt@swinland.com (812) 425-0055 Address (numberiand street, city, state, country, and ZIP code) 605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 I. SELLERS)/GRANTOR(S) Seller 1 - Name as it appears on conveyance document Seller 2 - Name as it appears on conveyance document Jared T. Gray Janice Gray Address (numberr,and street) Address (number and street) 519 W Morton St 519 W Morton St City, State and ZIP Code City, State and ZIP Code Oakland City, IN 47660 Oakland City, IN 47660 Country Country United States of America United States of America Email Address lephone Number Email Address Telephone Number oFY- 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 transferred of real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. Sign!Siur eller Signature of Seller � rinted Name of Seller Date Signed (mm/dd/ Printed Name of S Date Signed (mm/dd/yyyy; Jared T. Gray yyyy) Janice Gray 7/28/2026 7/27/2026 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 Justin Thomas Cody Address (numberiand street) Address (number and street) 519 W Morton St; IL City, State and ZIP Code City, State and ZIP Code Oakland City, IN '47660 till Country Country J U Z026 United States of America Email Address Telephone Number 4.J1- �� Email Address Gli IN Tel phone Number T Y �. SSO�NCOj J � Pursuant to IC 6-11-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that ap J7FOR YES NO CONDITION YES NO CONDITION ❑ 1. Will this property be the buyer's primary residence? Q ❑ 3. Homestead ❑ 0 4. Solar Energy Heating or Cooling System ❑ 2� 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: ❑ 0 5. Wind Power Device ❑ Q 6. Hydroelectric Power Device Address (numberland street) ❑ © 7. Geothermal Energy Heating or Cooling Device 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/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) Signa ure of Bu er 1 � �t11l�c (k®� C Signature of Buyer 2/Spouse Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) Justin Thomas Cody 7/28/2026 Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number SSN: Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number Page 3