HomeMy WebLinkAboutHomestead_HigginsI\DIA\.�SALESDISCLOSUREFORDI SDFID SDOID 719242 , Page?
D.PREPARER
Emily Smith Closing Agent
� Reparero(rheSalesDiuloSVreFOm� T"�tle
�OS S.E. MLK Jr., Blvd. Southwestem Indiana Land Title Inc.
AAdrecc(Numb•randSVee[) Lompony
IEvansville, IN 47713-
c.00�.�on�o�/�nnnivn�o) . .
Chades J. Brasellon Jr.,Trustee ChaAes J. Braselton Testamentary Tr..
Seller i- A'ame ar appears m ranveyon[e dotvmer.[
2870 lon Ave.
ACdress (Number and Sbret)
Sullivans Island, SC 29462-
Ciry, Smte, and 21P LoAc
TrlenhoneNum6er E-nmil
Paul M. Braselton�Trustee Charies J. Braselton Testamentary Tr.
Seffer 2� Nome ns opymn on conve}ana dxumen[
6065 S. Lincoln
Add�ess (NUmber ond Svre[)
Fort Branch, IN 47648-
Ciry.Smre, andZfPCode
Under penalties of perjury, l hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and comple[e as re uired b law, and is prepared in accordance with IC 6-1.1-5.5 "Real Proper Sales isclosuFe A
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F.BUYERS/GRA�TEES -APPWCATIONFORPROPERTYTAXDEDUCTIONS-IDENTIFYALLITEMSTHATAPPLY
John M. Higgins
Quyer]�Nomeasoppears mm�veyanredorument Bu��er2-Nnmeosrsppeonancanvr}nncedxument
Add�ess (Nnm,her and SrrreQ
uy, Smte, nnd ZIPCOdt
THE SALES DISCLOSORE FORD1 MAV BE USED TO APPLV FOR CERTAI,\ DEOURIOYS FOR
❑X ❑ 1. lNill this property be the buyer's primary
residence? Provide compleie address of p�'mar�
residence, including county:
7093 W. 250 S.
Address (Number anJ S[reetJ
Ov+ensville, IN 47665 GIBSON
Cim. RarellPCodr Counn
�� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? Ifyes, provide
complere address of residence being vacated,
induding county:
Address (NUmher und SnrerJ
Ciry.SmteZIP
Addrect (NUmAer anASn¢e[)
Ciry, Smm, anA7.IP Cade
OF THOSE THAT APPLY.
QX � 3. Homes[ead
� Solarfner�c��abng/Cooling System
� Q 5. Wind Power Device
❑ Q 6. Hydroelectric Power Device
❑ Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this property a residential ren[al property?
� Q 9. N'ould you like to receive tax s[atemen[s for this
property via e-mail? (Provide contoct informauon
below. Please see instructions%r more information.
�bt available in all coundes.J
o�� ��'o'�S=�4o_OOd. /77`-Q�/
Primury0�0er7'uwnerton[ac[nnme E-mail
Under penal[ies o(perjury, 1 hereby cer[i(y that [his Sales Disclosure, to the bes[ o(my knowledge and 6elie(, is true, wrrect
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/O[her numbers are no[ necessary if no Homestead Deduc[ion is
being filed.)
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SDigitso(Social5ecuriryh'mnber
Signorvre o(Bvyer2/Spoux
Printed Le�o/ Name o/Qvycr 7/Spause
(NH/DJ/Y!YYf
Las[ 5 di,qits ojBuyer 2/Spovse Driver's Sm[e Last 5 UigitsoJSocial Securiry
,Vumber LUrense/lU/O[her Num6er