HomeMy WebLinkAboutHomestead_Embry (2)H. PREPARER
Preparer of the Sales Disclosure Form
Title
Milton Norman
Settlement Agent
Company
Email Address
Telephone Number
Hometown Title LLC
orders@hometowntities.com
( 812 ) 461-6399
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
1. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
James A. Verley and Barbara A. Verley as Trustees of the James A. Verle
baz ",let
Address (number and street)
Address (number and street)
561 S State Road 57
( ail �F
City, State, and ZIP Code
City, State, and ZIP Code
Oakland City, IN 47660
Country
Country
us
mail Address )
Telephone Number
Email Address
Telephone Number
lig(�`, 0Q_3. i'YNI
(Flz) 79- 3
W Afrte
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Under penalties o perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete as
required bylaw, 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.
gn ture of Seller
i re of eller
Tinted Name of Seller
Date Signed (mmldd/yyyy)
Prlpted Name of Seller }
r'
a e Signed (mm/dd/yyyy)
James A. Verley, Trustee
07/30/2026
JJQ rb'� 44
07/30/2026
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS —IDENTIFY ALL LY
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it appears on conveyan doc e t
K lee Embry
Logan Murfin
Address (number and street)
Address (number and street)
5717 Forrest Park Dr
5717 Forrest Park Dr
City, State, and ZIP Code
City, State, and ZIP Code
Evansville, IN 47720
Evansville, IN 47720
Country
Country /
GreSONtA
us
us
Email Address
Telephone Number
Email Address
Tele do f�'
p JR
kyleeembryll@gmail.com
( 812 ) 484-9176
logan.muffinO2@gmail.com
g @gmail.com
( 812 ) 549-3744
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
1. Will this property be the buyer's primary
® D
® D 3. Homestead
residence?
D ® 4. Solar Energy Heating or Cooling System
D ® 5. Wind Power Device
D ® 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
D ® 6. Hydroelectric Power Device
D (R 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
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 6-1.145.5. 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 Lkense/iD/Other Number is necessary only if a Homestead Deduction is being filed)
f Buye ?
M
Signature of Buy r 2/Spous
ri d Legal Name of Buyer 1 Sign Date (MM/DD/YY)
C
Printed Legal Nalffie of Buyer Spouse Sign Date (MM/DD/YY)
Ky Embry 7/30/2026
Logan Murfin 07/30/2026
Last 5 Digits of Buyer 1 SSN/Drivers License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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y 01� a 0
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