HomeMy WebLinkAboutHomestead_QueenH. PREPARER
Preparer of the Sales Disclosure Form
Title
Wilchela Connolly Dircks
Settlement Agent
Company
Email Address
Telephone Number
Re ional Title Services LLC
closings@regionaltitlellc.com
( 812 ) 759-5555
Address (number and street, city. state, country, and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
1. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document
Seller 2 - Name as appears on conveyance document
Sandra K. Schmits, as Trustee of the Joseph M. Schmits and Sandra K.
r4s 9qAv,61e LwiZ `,%i
Address (number and street)
Address (number and street)
I L
545 E Old Petersburg Road
9E
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Country
Country OC T 16 2026
US
Email Address
Telephone Number
Email Address
Telephone Number
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge an a plete as
required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally fals�fi� All4 il"transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
Signature f Seller
Signature of Seller
{
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Printed Name of Seller
IDate Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/ddlyyyy)
Sandra K. Schmits, Trustee
10/09/2026
10/09/2026
J. BUYER(S)/GRANTEE(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 conveyance document
Dane M. Queen
Hartee Har e
Address (number and street)
Address (number and street)
304 Hawthorne Drive
304 Hawthorne Drive
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Princeton, IN 47670
Country
Country
US
US
Email Address
Telephone Number
Email Address
Telephone Number
dane.queen83@gmail.com
( 812 ) 779-6289 71
harleeharpe@gmail.com
( 812 ) 319-5697
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Forth 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
® O 3. Homestead
residence?
O ® 4. Solar Energy Heating or Cooling System
O (9 5. Wind Power Device
O ® 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
O ® 6. Hydroelectric Power Device
O ® 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
_ V� _ -� u:)- oc) , q 3O - oc9l
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, SSA/Driver's LicenseAD10ther Number is necessary only if a Ho estead Deductioq is being filed.)
Signature er 1
Sign
a of yer 2/Spa e
PrIf—ted Legal Name of uyer 1 Sign Date (MMIDD/YY)
Printed Legal Name of Buyer 2/00use Sign Date (MWDD/YY)
Dane M. Queen 10/9/2026
Harlee Harpe 10/09/2026
Last 5 Digits of Bu er 1 55 /D)gs License/ID/Other Number
Last 5 Digits of B r 2 use 5SN/Driver sLicense/ID/Other Number
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