HomeMy WebLinkAboutHomestead_AdamsH.PREPARER
Preparer of the Sales Disclosure Form
Title
Milton Norman
Settlement Agent
Company
Email Address
Telephone Number
Hometown Title LLC
orders@h metowntitles.com
( 812 ) 461-6399
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
f. SELLER(S)%GRANTAR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
The Unsupervised Estate of Timothy A. Hiatt, filed July 27, 2026 in the Gil
Address (number and street)
Address (number and street)
831 Wood St
� 3 L1 � CM
City, State, and ZIP Code
City, SXate, and ZIP Code
J L4 —1(b
Princeton, IN 47670
/`(iLe 1 N •
Country
Country
u5
Email Address
Telephone Number
Email Add rass
Telephone Number
s p
Under penalties of pery' ,:I hereby certify this Sales Disclosure, to the best of my knowledge and belief is true, correct, and complete as
required by Jaw, and Is prepared In accordance with 1C 6.1.1.6.5. 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.
Signature of Seller
Signature of Seller
Pri led Name of Seller
Dat igned.(mm/dd/ }
fi ted Name of Seller Date S' re2d (mm/dd/yyyy)
Sharla K. Bloebaum, Co -Personal Repre
3,
eb A • F��t4i{- 8WUQ r � — ' �/
J. BU.YER(S)/GRANTEE(S) — APPLICATION FOR.PROPERTY TAX DEDUCTIONS — IDENTIF T
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it appears on convV3n d urn
13
Tyler R. Adams
AL-
Rikkie R. Adams
Address (number and street)
Address (number and street)
11833 Millersburg Rd
11833 Millersburg Rd 4 ME
City, State, and.ZIP Code
City, State, and ZIP Code
Chandler, IN 47610
Chandler, IN 47610
Country
Country
us
us AIR/lqA
Email Address
Telephone Number
Email Address
slap one um er
dkkie.r.miller@gmail.com
( 812 ) 598-4245
admzt90@gmail.com
( 812 ) 901-8699
Pursuant to IC 6-IIA-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
0 0 3. Homestead
® O residence?
p 2 4. Solar Energy Heating or Cooling System
0 ® S. Wind Power Device
O 2. Does the buyer have a homestead to be vacated
or this residence? If yes, provide address:
0 ® 6. Hydroelectrid Power Device
Q ® 7. Geothermal Energy Heating or Cooling Device
(knowledge
Address (number and street)
City, State, and ZIP Code County
Under penalties of perjury, I hemeby.certify that this Sales Disclosure, to the best of my 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. (biota; Both spouse's
Information, SSN/Or/ver's Llcense4DlOther Number is necessary only if a Homestead Deduction is being filed.)
Signature of Buyer 1
Signal Buyer 2/S use _.
Printed Legal NaMe of Buyer 1 Sign Date /D )++
0
Tinted Legal Name of Buyer 2/Spouse Sign D (MM/DD/my)
Tyler R. Adams
Rikkie R. Adams
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/11310ther Number
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