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HomeMy WebLinkAboutHomestead_Tate (10) H. PREPARER Preparer of the Sales Disclosure Form title _ Melonie R.Leonard Escrow Officer Company Address(number and street,city,state,country,and ZIP Code) 4610 S. Ulster Street, Ste. 100, Denver, CO 80237 I.SELLER(S)IGRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on con vQ e o ent Ziad Y.Abazid Address(number and street) Address(number and street) -Q 5443 WADE PARK BLVD,APT.1311 City,State,end ZIP Code City,State,and ZIP Code BAN 3 �0?5 RALEIGH,NC 27607 Country I Country USA Email Address Telephone Number Email Address ri):43s,..r;:lizeZetielep ne Number N/A ( . ) N CO/ G Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,Is true,cosr4Ni,0nplete 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 transferred real property,or omits or falsifies any information required to be provided,commits a Level 6 felony. Signature of Seller Signature of Seller Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/ddi iyyy) Zih P ii-girLtSo i'2-'1I-20-Y J. BuIYER(S)IGRANTEE(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 Peggy C.Tate Address(number and street) Address(number and street) 330 S Whitetail Way City,State,and ZIP Code City,State,and ZIP Code Princeton, IN 47670 Country Country 42551 EmailAddress for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION a' © O 1.Will this property be the buyer's primary El 0 3. Homestead .•;r. i 0 0 4.Solar Energy Heat •,,.t v.. ,` residence? n "" —_�— O © 2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device +r I. for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device City,State,end ZIP Code County a 6,1 Z 01-3 d 1 _(0 0 I,I . 3 6 3— 0 Z3 . Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct,and complete I