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Homestead_Michel (2)
INDIANA SALES DISCLOSURE FORM SOF ID: __. Page 2 D.PREPARER Kelly A.Lonnberg Attorney Preparer of the Sales Disclosure Form Title 20 N.W.Fourth Street.P.O.Box 657 Bamberger,Foreman,Oswald 8 Hahn,LLP Address(Number and Street) Company Evansville,IN 47708 812/452-3505 klonnberg @bamberger.com City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Jessica L.Williams Seller l-Name as appears on conveyanadocument Seller 2-Name as appears on conveyance document _-16 LNkb s(Number and street) `� Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and Sbmplete.as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ot/le Ui r/„t�l9�v- Signature of Seller Signature of Seller Jessica L.Williams 061 (5/2013 Printed Name of Seller Sian Date(M.MIOD/YYI'1) Printed Name al Seller Sian Date IMM/OORlY1l F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY Matthew B.Michel Buyer I-Nome as appears on conveyance document Buyer 2-Name as appears on conveyance document 2905 E.100N Address(Number and Street) Address(Number and Street) Princeton,IN 47670 Telephone Number E-mail TILE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES .No CONDITION 0 ❑ 1.Will this property be the buyer's primary © 0 3.Homestead residence? Provide complete address of primary ❑ NI 4.Solar Energy Heating/Cooling System residence,including county: ❑ 2 ig 950 E. t00N 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Princeton,IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ SI 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. O�h Not available in all counties.) Address(Number and Street) City,State ZIP Code County a6 -1).-o3- 4 oo - Ooo.4 at,-O 1 Primary property owner contact name E-mail 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,"Real Property Sales Disclosure Act".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being dt` Signature of Buyerl / Signature of Buyerl/Spouse Matthew Michel ©,S /2 y/A 0 Number License/ID/Other Number