HomeMy WebLinkAboutHomestead_Simms1. PREPARER
3reparer of the Sales Disclosure Form
Aatthew Jarvis
'ompany
:�nl ithimpctprn Indiana Land Title
Title
Escrow Officer
E-mail address
matt@swinland.com
4ddress (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
Michael Lee Foote
Address (number and street)
740 N 275 E
City, State and ZIP Code
Princeton. IN 47670
Country
United States of America
Email Address
Telephone number
(812) 425-0055
Seller 2 - Name as it appears on conveyance document
Haley Victoria Foote
Address (number and street)
740 N 275 E
City, State and ZIP Code
Princeton, IN 47670
Country
United States of America
Email Address
elephone Number
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 pre d i ccordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of transferred real property, or
omits or falsifie are for ation regyired toy be provided, commits a Level 5 felony.
Printed Name of S
Michael Lee Foote
re of Seller
'Date (mm/dd/ Printed Name`-bf Sell
yyyy) Haley Victoria Foote
9/25/2026
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 appears on
Casey Simms Lauren Simms
Address (number and street) Address (number and street)
N31106 Square Bluff Rd N31106 Square Bluff Rd
ZIP C d
Date Signed (mm/dd/yyyy)
9/25/2026
City, State and ZIP Code Clty, State and o e c.��
�
Vlair, WI 54616 Blair, WI 54616 / rl� a.
Country I
Country
United States of America
United States of America
Telephone Number Email Address
Email Address
Zl2 -3172
P„mnAnt 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
0 ❑ 1. Will this property be the buyer's prima residence?
❑ 0 2. Does the buyer have a homestead to be vacated for
this residence? If yes, provide address:
Address (number and street)
City, State, and ZIP Code
County
Number
36467
YES NO CONDITION
0 ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
❑ 0 5. Wind Power Device
❑ 0 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating or Cooling Device
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/Driver's
License/ID/Other Number is necessary if a Homestead Deduction is being Med.) J
ignature of Buyer 1
Printed Legal Name of Buyer 1 g/25/2 Date
(MM/DD/YY)
26
Casey Simms
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
SN: 1 `2? � � iG x 04
ature of Buyer 2/Spouse
Printed Legal Name of Buyer 2/Spouse 9 Sign
Date
6 (MM/DD/YY)
Lauren Simms
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Numbei
SSN: & I// kto iW X Dl-:
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