HomeMy WebLinkAboutHomestead_Short (2)H. PREPARER
Preparer of the Sales Disclosure Form
Title
Matthew Jarvis
Escrow Officer
Company
E-mail address
Telephone number
Southwestern Indiana Land Title
matt@swinland.com
(812) 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
B.I. Trust, LLC, an Indiana Corporation, more correctly identified as B I
Trust, LLC, an Indiana Limited Liability Company
Address (number and street)
Address (number and street)
42 W 225 N
City, State and ZIP Code
City, State and ZIP Code,
Princeton, IN 47670
Country
Country
United States of America
Email Address
Telephone Number
Email Address
Telephone 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 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.
ig t f
Signature of Seller
P nted Name of Seller
Date Signed (mm/dd/
Printed Name of Seller Date Signed (mm/dd/yyyy)
Joey M. Boxell, Member
yyyy)
9/25/2026
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT AP LY
Buyer 1 — Name as it appears on conveyance document
nt
Buyer 2 — Name as it appear f"n
Louis D. Short
Address (number and street)
Address (number and street)
488 W Glendale St
City, State and ZIP Code
City, State and ZIP Code
Princeton, IN 47670
Country
Country
United States of America
GIBSON CO I/ AI
Email Address
Telephone Number
Email Address
ele ne Number
Idshort23@gmail.com
(812) 664-6201
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
t� ❑ 1. Will this property be the buyer's primary residence?
e ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
❑ 2. Does the buyer have a homestead to be vacated for
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
/J ,
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 spouse's information, SSN/Driver's
LicensefiD/Other Number is necessary if a Homestead Deduction is being filed.)
igna re of J{uyer 1
Signature of Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Louis D. Short 9/25/2026
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
SSN: G ci YA% ®L,;