HomeMy WebLinkAboutHomestead_StillwellH. PREPARER
Preparer of the Sales Disclosure Form
Title
Abbey Moore
Closing Agent
Company
E-mail Address
Telephone Number
Columbia Title, Inc
abbey@columbiatitlegroup.com
(812) 471-8563 ext. 400
Address (number and street, city, state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
1. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2— Name as appears on conveyan t
Jordan M. Helton
Address (number and street)
Address (number and street)
�'
2635 Secretariat Court
2�
City, State, and ZIP Code
City, State, and ZI de
Evansville, IN 47720
Country
Country k2113soN
CCUNIY
USA
p 1 (z,
E-mail Address
Telephone Number
E-mail Address
TbWone Number
jordanheiton334@gmail.com
(812) 766-0775
Under penalties of perjury, 1 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.
Si nature gi S It 4C.A I
Signature of Seller
Printed Name of Seller
Date Signed (mmlddlyyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Jordan M. Helton
7/31/2026
7/31/2026
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
Andrew Stillwell
Ashly Stillwell
Address (number and street)
Address (number and street)
2510 West 800 South
2510 West 800 South
City, State, and ZIP Code
City, State, and ZIP Code
Fort Branch, IN 47648
Fort Branch, IN 47648
Country
Country
USA
USA
E-mail Address
Telephone Number
E-mail Address
Telephone Number
andrew.d.Stiliwell@gmail.Com
(812) 677-3151
ashly.stillwell@yahoo.com
(812) 677-3141
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
X❑ ❑ 3. Homestead
1. Will this property be the buyer's primary
M ❑
residence?
❑ Fx_1 4. Solar Energy Heating or Cooling System
❑ ❑X 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
❑
for this residence? If yes, provide address:
❑ FX_1 6. Hydroelectric Power Device
❑ ❑X 7. Geothermal Energy Heating or Cooling Device
Q(D _ �Q _ �`� _ �t Yam.. , 3 L17 _ C r}�
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 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 LicepseliDlOther Number is necessary only if a Ho estead Deduction is being filed.)
Signature of Bueel
ign tur` . f Bu 21Soouse
Printed Legal Name of Buyer 1 Sign Date (MMlDD/YY)
Printe g ame of Bu r 2/Spouse Sign Date (MM/DDfYY)
Andrew Stillwell 7/31/2026
Ashly Stillwell 7/31/2026
Last 5 Digits of �uy1SN/
river's License/iDlQther Number
La git uSpouse SSN/griver's License/ID/Other Number
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