HomeMy WebLinkAboutHomestead_Burns (3)H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company E-mail address Telephone number
Southwestern Indiana Land Title
it
matt@swinland.com 12) 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. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document
Oakland City University, Inc. an Indiana Nonprofit Corporation
Address (number and street) Address (number and street)
138 N Lucretia
City, State and ZIP Code City, State and ZIP Code
Oaklande City, IN 47660
Country Country
United States of America
Email Address Telephone Number Email Address Telephone Number
g• �B r00 Al
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.
Signature eller
�=__
Signature of Seller
Printed Name of Seller Date Signed (mm/dd/
Phillip Reinbrecht, Trustee yyyy)
Printed Name of Seller Date Signed (mm/dd/yyyy)
9/22/2026
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT A
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it app socent
Jcla�2
Tifani Burns
Address (number and street)
427 Dale St
Address (number and street)
SEP 2
3 2026
City, State and ZIP Code
City, State and ZIP Code
Oakland City, IN 47660
(-A 1
Country
United States of America
Country G/IBSON COUN TyAUD►TOR
Email Address
.
Telephox/V
, - n—/
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
I" ❑ 1. Will this property be the buyer's primaryresidence?
❑ 3. Homestead
❑ 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
❑ 0 .6. Hydroelectric Power Device
Address (number and street)
❑ 0 7. Geothermal Energy Heating or Cooling Device
a�- I1-I-��- 30A-003. V i-o�7
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 spouses information, SSN/Drivers
License11D10ther Numbe 's necessary if a Homestead Deduction is being frled.)
St'hature of Buyer -- Signature of Buyer 2/Spouse
rme
Printed Legal of Bu er 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DDNY)
Tifani Burns 9/22/2026
_ast 5 Digits offBB'ye�rJ1 S N/Driver's License/ID/Ot�h+erNumber
3SN: —
Last 5 Digits of Buyer 2/Spouse SSN/Drive r's License/ID/Other Number
�7 Q 7 l� -" , $-3,1-10
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