HomeMy WebLinkAboutHomestead_Williamson (7) H. PREPARER 1
Preparer of the Sales Disclosure Form
Title
Sandra L. Hicks Attorney
Company
'
Address (number and street. city, state, country, and ZIP Code)
' 843 S. 9th Avenue, Haubstadt, Indiana 47639
1. SELLER(S)IGRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 -Name as appears on conveyance document
William A. Folsom.Jr. Trustee of the Witham A.Folsom.Jr Revocable Living Trust detect 7/8122
Address (number and street) Address (number and street)
4195 S 700 W
City, State, and ZIP Code City, State. and ZIP Code
Owensville, IN 47665
Country Country
USA - Gibson County, IN
Email Address
Telephone Number Email Address Telephone Number
( ) ( )
Under penalties of perjury, I hereby certify 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. A person who knowingly and intentionally falsifies the value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
N S n u of Seller Signature of Seller
AAY444/
TAX DEDUC • - r EN Y A ja,. AT APPLY
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it - •. . 1, .nv , '.'ocument
Susan M. Williamson
Address (number and street)
Address (number attitt�ee�
804 E. Vine Street 'H-1 VV 7 20 2 .
City. State. and ZIP Code City. State. and ZIP Code
Fort Branch, IN 47648 •
Country Country G 0 a
USA - Gibson Count CI"
Email Address y C LINTY - ��•
Telephone Number Email Address Telephone Number
( ) ( )
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1 . Will this property be the buyer's primary 0 0 3. Homestead
0
residence? El a 4. Solar Energy Heating or Cooling System i
❑ 0 2. Does the buyer have a homestead to be vacated ❑ [] 5. Wind Power Device j
for this residence? If yes, provide address: p 6. Hydroelectric Power Device
Address (number and street) El p 7. Geothermal Energy Heating or Cooling Device
I
City. State. and ZIP Code County ,
QU2 - 1g - tRI -- )k-k - Cita- _is. 0 _ Is ,
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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