HomeMy WebLinkAboutHomestead_Buck (2)H. PREPARER
Preparer of the Sales Disclosure Form
Title
Escrow Officer
Kris Coon
Company
Regional Land Title
E-mail Address
kris@regional-It.com
Telephone Number
(812) 470-1300
Address (number and street, city, state, country, and ZIP Code)
4600 Washington Avenue, Suite 102, Evansville, IN 47714
1. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Melinda Bradshaw
Address (number and street)
Address (number and street)
505 N Main Street
City, State, and ZIP Code
City, State, and ZIP Code
Patoka, Indiana 47666
Country
Country
USA
E-mail Address Telephone Number E-mail Address Telephone Number
' • t C.1, (812) 453-0647
Under penalties of perjury, I Rrdby certify t is Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete as
IC 6-1.1-5.5. A who knowingly and Intentionally falsifies the value of transferred
required by law, and is prepared in accordance with person
real property, or omits or falsifies any information yQuired to be provided, commits a Level 5 felony.
Signature of Su / Signature of Seller
Printed Name of Seller Date Signed (mntlddlyyyy) Printed Name of Seller Date Signed {mrnlddlyyyy)
Melinda Bradshaw September 11, 2026
J. BUYER(S)IGRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1— Name as it appears on conveyance document
Buyer 2 — Name as it appea
c
v
ance
oc
nt
Braden Ralph Buck
Address (number and street)
Address (number and street)
931 N 225 W
City, State, and ZIP Code
City, State, and ZIP Code SEP 14 2026
Princeton, Indiana 47670
Country
Country
USA
E-mail Address
Telephone Number
E-mail Address
GIBSON COUN
tuber
AUDITOR
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 Z ❑ 3. Homestead
z ❑ residence? ❑ 4. Solar Energy Heating or Cooling System
VfoDoes the buyer have a homestead to be vacated 5. Wind Power Device
❑r this residence? If yes, provide address: ® 6. Hydroelectric Power Device
Address (number and street) ❑ m 7. Geothermal Energy Heating or Cooling Device
City, State, ZIP code, and 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
IC 64.1-5.5. A person who knowingly and intentionally falsifies the value of
as required by law, and Is prepared in accordance with
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 LicenseAD Other Number is necessary only if a Homestead Deduction is being fled.)
Signature of Buyer 1 p,�
0�r
Signature of Buyer 21Spouse
Printed Legal Name of Buyer 1 Sign Date (MM1D /YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YIY)
Braden Ralph Buck September � 12026
Last 5 Digits of Buyer 21Spouse SSN/Drive{ s License/I U/Vrner IVwuuc,
Last 5 Digits of 8u 1 SIN/ rivs L'cense/ID/Other Number
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