HomeMy WebLinkAboutHomestead_BaileyH. PREPARER
Yreparer of the Salmi; Disclosure Form
Tdle
Katie Felly
Escrow Officer
Company
Email Address
Telephone Number
Foreman Watson Land Title
itfeity@fw-It.com
(812 ) 909-4543
Address (number and street, city, state, country, and ZIP ~rode)
7412 Eagle Crest Blvd Evansville, IN 47715
h SELLER(5)IGRANTOR(S) -
Seller 1 - Name as it appears on conveyance document
Seller 2- Name as appears on conveyance document
Bernard J. Spindler, Jr.
Lori M. Spindler
Addr ( ti r �n`d�street) t i ram\
Address (number and )
City, State, aln ZIP Code 7
( lr�
City, Stale, and ZIP Ccxfe
Country
Country
us
us
Email Address
Telephone Number
Email Address Telephone Number
(.812 ) 483-8961
Ispindler3360 rt�. gmail.com ( 812 ) 664-2511
under pertaltles of perjury, I hereby certlfy thls Sates Dlaelosure, to the beat of my knowledge and bellef, Is true, correct, and complete.as
required by.taw, and la prepared In accordance with IC 04.14.6. A person: who knowingly end intentionally. 1`e141190 the value of transferred
real property, or onilts or'MI91flaAany information required to be provided, commits a Leval 6 felony.
Si efure ells
-1 —if/ /11
Si afore of Salle
4 &J".
Printed Nate of 1[ r
Data Signed (mmlddfyyyy)
rated Name of Seller
Dale Signed (mm/ddlyyw)
Bemard J. Spindler, Jr.
18131/26
Lori M. Spindler
8131126
J. BUYER(S)IGRANTEEM -� APPLICATION FOR PROPERTY TAx DEnuCTIONS -- IDENTIliFAF_r6Y
Buyer 1- Name as it appears on conveyance document
Buyer 2 - Name as it appears on conytyahc d urns
Reece Bailey
Kristen Bailey
Address (number and street)
Address (number and sf seat)
5359 E State Road 168
5359 E State Road 168
City, State, and ZIP Code
City, State, and ZIP Code
0 rk , (' LQ
Fort Branch iN 47648
Country
Country
US
US CZ
Email Address G�
Telephone Number
Email Address
A
Ce'ec-0- A� n�a,1� �J
(812 ) 239-8915
(812 ) 664
7
Pursuant to IC 6-1.i-12 k4 the
lee Disclosure Form may he used. to apply for certain deductlons: Identify all of those that apply!
YES NO CONDITION
YES NO CONDITION
® ❑ 1. Will this property be the buyer°s,prltrtary
❑ ❑ 3. Homestead
residence?
❑ ® 4. Solar Energy Heating or Cooling System
❑ El 5. Wind Power Device
® 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
❑ ❑ 6. Hydroelectric Power Device
® 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
_ ,C� `� 0c, - ccj"" , :5-IS
City, State, and ZIP Code County
Under penalties of perjury;) hereby c eriify that`thla Sales Disclosure, to the beat of my knowledge and belief, Is true, correct, and complete
as required by law, and is prepared_In accordance with IC 6-1.1-f>.6. A person who knowingly and Intentionally falsifies the value of
transferred real property, or omits or falsifies any Information required to be provtdad, commits a. Level 6 felony. (Note. Both spouse's
Intiormation, SSM Driver's lfcenseRD/other Number is necessary only Its Homestead Deduction is being filed.)
Signatureof Buyer 1
Si nature of uyer 2/Spouse '
Printed Legal Name of Buyer 1 Sign Data (MMIDDIYY)
Printed Legal Name of Buyer2lSprruse Sign Date (MMIDDiYY)
Reece Bailey 8/31/26
Kristen Bailey 8131/26
Last 5 Digits of Buyer i SSN/Driver's LicenseliD1011her Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License11D101hor Number
Last 5 of SSN: 5 �3'lpr-5
Last 5 of SSN: S I
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