HomeMy WebLinkAboutHomestead_NethercuttH. 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 (number and 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
Jedidiah P. Gamble
Address (number and street)
Address (number and street)
812 S Hart St
City, State and ZIP Code
City, State and ZIP Code
Princeton, IN 47670
Country
Country
United States of America
Email Address
Telephone Number
Email Address
Telephone Number
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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 knowingly
person who and intentionally falsifies the value of transferred real property, or
omits or falsifies any information required to be provided, commits a Level 5 felony.
ignature of Seller
Signature of Seller
Printed Name of Seller
Jedidiah P. Gamble
Date Signed (mm/dd/
yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
8/14/2026
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J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS
- IDENTIFY pp
Buyer 1 - Name as it appears on conveyance document
Buyer 2 - Name sit on conveyance document
Skyler James Nethercutt
Address (number and street)
426 W 2nd Street
Address (number andr�et)
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City, State and ZIP Code
City, State and ZIP Code
Mt. Carmel, IL 62863
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Country
Country GOU
United States of America
613SON
Email Address
Telephone Number
Email Address
Telephone Number
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
0 ❑ 1. Will this property be the buyer's primarV residence? 0 ❑ 3. Homestead
❑ 0 2. Does the buyer have a homestead to be vacated for ❑ 0 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: ❑ 0 5. Wind Power Device
Address (number and street) ❑ 0 6. Hydroelectric Power Device
❑ 0 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, SSN1Driver's
License/lD/Other Number is necessary if a Homestead Deduction is being filed.)
Sin tune of Buyer 1 t
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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)
Skyler James Nethercutt 8/14/2026
,Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
SSN: 'j I L( q •
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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