HomeMy WebLinkAboutHomestead_SettleH.PREPARER
Preparer of the Sales Disclosure Form
Title
Wilchela Connolly Dircks
Settlement Agent
Company
Email Address
Telephone Number
r Regional Title Services LLC
closings@regionaltitleflc.com
( 812 ) 759-5555
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
L SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document
Seller 2 —Name as appears o o d
Heather Lynn Bullington
;rmnt
Address (number and street) {
Address (number and street)
7981 S Andee Lane
City, State, and ZIP Code
City, State, and ZIP Code SEp O
C1I"" o
Fort Branch, IN 47648-1548
Country
Country
us
Email Address
Telephone Number
Email Address Gi8-s-OP4
one Number
hlbullington@hotmaif.com
( 812 ) 568-9176
C
Abmro
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 ac ordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of transferred
real pro rty, or omits or falsifies an information required to be provided, commits a Level 5 felony.
ign u of Sal r
Signature of Seller
Pr' a of r
Date Signed (mm/ddlyyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy) j
Heather Lynn Bullington
09/01/2026
09/01/2026 j
_
J. BUYERS)/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
Jarrett Settle
Address (number and street)
Address (number and street)
48W 800S, Apt 8305
City, State, and ZIP Code
City, State, and ZIP Code
Fort Branch, IN 47648
Country
Country
us
Email Address
Telephone Number
Email Address
I Telephone Number
jarrettwsettlel9@gmail.com
( 812 ) 550-7335
( )
I
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
® ❑ 3. Homestead
® ❑ residence? I
❑ ® 4. Solar Energy Heating or Cooling System
I
❑ ® 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
❑ ® for this residence? If yes, provide address:
i
Q ® 6. Hydroelectric Power Device
❑ (N 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
-% _ n _ 1Q _ 1r- ?-)- O0\ F\\ _ Oa(,
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 LicenselrD/Other Number is necessary only if a Homestead Deducdon is being filed.)
5i nature of Buyer 1
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)
Jarrett Settle 9/1/2026
09/01/2026
Last 5 Digits of Buyer 1 SSN Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Drivers License/ID/Other Number
Page 3