HomeMy WebLinkAboutHomestead_Memmer H. PREPARER
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Preparrer of the Sales Disclosure Form
Arvireu 1460, 044._ Title
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Company
Address (number and street, cit,, state, country, and ZIP Code)
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I. SELLER(S)/GRANTOR(S)
Sl!el��ler 1 - Name as it appears on conveyance document Seller 2 - Name as appears on nveyance document
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Address (numb r and street) Address (number and street)
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ty, State, and ZIP Code -
Ci City, State, and ZIP Code A
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Country Country — --- , ?,0 - — - —
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person who knowingly and intentionall',��V,t,c the value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. ' `9�R
Signature of Seller Signature of Seller
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`rinted Name of seller Date Signed (mmldd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
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J. BUYERS)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY
B ,er 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance document
Address (number and street) Address (number and street)
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City. State, pnd ZIP Code �- City, State, and ZIP Code
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Country :3:try - --- -
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YES NO CONDITION ✓'
1. Will this property be the buyer's primary 0 3. Homestead y 0
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residence?
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4. Solar Energy Heating.Or Cgptirxg Sy. n
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tlr 2. Does the buyer have a homestead to be vacated O L ' 5. Wind Power Device
for this residence? If yes, provide address: O if 6. Hydroelectric Power Device
Address (number and street)
Q ge 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County raC - 1 I - 14
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Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete
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