HomeMy WebLinkAboutHomestead_Clem H. PREPARER
Preparer of the Sales Disclosure Form Title
Chris Sullivan Closer _
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd Ste 201,Evansville,IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Linda L.Folsom WilliamA.Folsom
Address(number and street) Address(number and street)
4195 S 700 W 4195 S 700 W
City,state,and ZIP Code City,state,and ZIP Code
Owensville,IN 47665 Owensville,IN 47665
Country Country
Same
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 falsities the value of transferred
real pro ierty,or omits or fats',es any information required to be provided,commits a Level 5 felony.
Si le qf-Se 1 '--- 4ofteller
b44s-r-Ar,____
P nted Name of eller Date signed(mm/dd/yyyy) ed Name of Seller Date signed(mm/dd/yyyy) .
Linda L.Folsom 02/10/21 WilliiamA.Folsom 02/10/21
J. BUYER(S)/GRANTEE(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
Carrie Coomer Clem
Address(number and street) Address(number and street)
802 E Walnut
City,state,and ZIP Code . City,state,and ZIP Code
Fort Branch,47648
Country a- 4 Country
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:
a
YES NO CONDITION YES NO CONDITION o0
`„� r--, 1.Will this property be the buyer's primary yl O 3. Homestead o -t
I]`�! residence? El ( 4.Solar Energy Heating or Cooling System ° H
2. Does the buyer have a homestead to be vacated 0 r 5.Wind Power Device tzi
z w t-I
O for this residence? If yes, provide address: 0 / 6. Hydroelectric Power Device y too
Address(number and street)
0 V 7. Geothermal Energy Heating or Cooling 2417
City,state,and ZIP Code County
26-19-18-304-000.430-026 o
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