HomeMy WebLinkAboutHomestead_Haynes1\DIA\ASALESDISCLOSUREFORDI SDFID SDOID 1272200 Page2
D.PREPARER
Samantha Culsinger
Feparer o([hr Scles Diulosvre Fam TiUe
226 W. Broadway Broadway Tille, Inc.
Addres (Number and Sv.el)
E. SELLER S GRANTOR S
Pamela L Bates
Srller ]� Mome ua nppevrs om m�vewn�r J«ummt Sel7er2 � Nume ns apyears m mmnnnce davmenl
729 S. Hall St.
Address (NUmner md SareQ Address (A'umbe� and Saeec)
Princeton, IN 47670.
Ci.}', Sm[
�' E�rnoil Tele huneNumber Email
Under penalties of perjury, 1 hereby cer[ify that this Sales Disclosure, to [he best o(my knowledge and belief, is we, correct
an omplete as require by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Property Sales Disclosure Act".
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onme aJSdirr .ti,qnarvre ofSeller
�1/Y1��G`L, f�-��S ��-CI-I�
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NTEES -APPLICATIONFORPROPERTYTAXDEDUCTIONS-IDENTIFYALLITEMSTHATAPPLY
Micah R Haynes
� r � .mnemeppmrsonmmevanredorument Buycr2-Nameusappevrsomm�ve�nnretlxvmmt
3305 Tamarack Ci. ApL 523
dCdren (A'umber ondSVeet) AEdras (Number anCSOret)
Evansville, IN 47715
THIS PROPERIY. IDEM'IF1' dLL Of THOSE THAT APPLI'.
t'FS f:0 [ONORION
❑x ❑ 1. Will this property be the buyer's primary� ❑x ❑ 3. Homestead
residence? Provide complete address of primary . olar Energy Heating/Cooling Sys[em
residence, including counp�:
729 S. HALL ST. ❑ Q 5. bVind Potver Device
Address/NUmberend50-xo) ❑ Q 6. Hydraelectric Po�ver Device
Princeton, IN a7670 GIBSON � � 7, Geuthermal Energy Heating/Cooling Device
Ciry. Smce ZIP CoOe CounN
�€] 2. Does the buyer have a homestead in Indiana m be ❑ �$• Is this properry a residential rental property?
vacared for this residence? If yes, provide ❑ � 9. Would you like to receive tax statemena for this
complete address of residence being vacated, ro e via e-mail? Provide conmct informorion
indudingrounty: 6elow.Pleaseseeinstrucpons � ormation.
hbr available in all counties.J
ede.MS/rv�mbe.a�ds�.M�7
02 (o- /,t _ /�-/o�- oa�. g3 D -o �b�
Ciry, Smte ZIP Ca:e Comry
Pnmary pmperry oumer co�mrt nume 6'-mail
Under penaltles of perjury, I hereby certify tha[ this Sales Disclosure, [o Ihe bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.]-5.5, "Real Property Sales Disclosure AcC. (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.)
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SignamreofBvye 1 Si9^a[ureo(BVyer2/Spouse
M�L'Gh. f2�u I�0.�r�S--�`69-2012
LastSdiglao�Buye�IDrlver's Sta[e LastSDigiCro(Sotial5xunryNumber LastSdigivo%Buy�er2/SpouseDnveri Smte CastSDigivo(Social5ecunry
Lirenre/!D/O[hzrNum6er Number License/lD/O[herNUmber