HomeMy WebLinkAboutHomestead_DixI\DU\ASALESDISCLOSUREFOR�1 SDFID ' SDOID 722728 ,��Page2
D. PREPARER ,_ - .�.. . � — , � : _
Peggy A. Conner Tille Pssistant
�PrepartroftlxSa/aDddamreFarm Ttle
3107 N. Green River Road Suite 740 7rustworthy Land Tiile Co., Inc.
Addras(NUmberand5treer) Campony
Evansville, IN 47715
E.SELLER S GILiNTOR 5 - � � ' � � � � -- �
Jason J. Weyer
Se11er ]� Name m aypean on romeynn[e dotummt &ller2 - Nome as aOP�rs on ronvryvnce datument
429 E. 790 S.
AdEn_cr(Nvmberand5oeet% Addr¢s(NUmDerand5vee[)
Fort Branch, IN 4764&
Ory, State, endLFCode Gry, Smte, a� LPCode
Tdr oneNumbrs E-mail Tele M+reh'umbei E-moil
Under penaltles of perjury, 1 hereby certify that this Sales Disdosure, [o [he bes[ of my knowledge and belief, is [rue, mrrec[
and.co e[�� t'red by law, and is prepared in accordance with IC bd.l-5.5, "Real Property Sales Disclosure Act".
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gnvtureo�lfe� SignatunoJSeller
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. UYER 5 NTEE S--APPLICATION FOR RROPERTYTAX IONS- IDE ' LL ITEMSTHATAPPLY ,'.-� - -� -
� Justin A. Dix Tasha A. Oakley
B � amemappmrsonconve�nnredavmrnl Buyer2-,Vamrasap . mnveyonaeJetumme
103 W. John SVeet 103 W. John SVeet
Addres(Numberand5ve¢�J Address(.YUmberond5deei)
Fort Branch, IN 47648- Fort B2nch, IN 4764&
�Ciry, Autg endZlV Cade C/ry.5mtr. orsd Z!P Cade
E-mail
TNESALESDISCLOSUREiORMMAYBEUSEDTOAPPLYFORCERTAIYDEDUR10K5F PERIY.IO OFTNOSETHATMPLY.
YES NO COYDRIOH YES NO COND1770N
Q � 1. lYili this proper[y be Ihe buyer's primary �x � 3. Homeste
residence? Provide complete address of primary . o ar Eoergy Heating/Cooling System
residence, intluding county:
429 E. 790 S. ❑ Q 5. Wind Power Device
.Addrm(Num6crund5tree[) ❑ Q 6. Hydroelectric Power Device
Fort Branch, IN a76a8 GIBSON � � 7 Geothermal Energy Hea[ing/Cooling Device
Ciry. SmrellPCOde lo�mry
�� 2. Does the buyer have a homestead in Indiana ro be � �$� �s [his property a residen[ial rental property?
vacated for [his residence? If yes, provide ❑ Q 9� Would you like [o receive [atc statements for this
complete address of residence being vacated, property via e-mail? (Provide contoct informadon
including county: 6elow. Pleasesee instructions for more information.
Notavaila6le in all counries.)
Addres(NUmberaMSbeet) �/ ,�9 i9. ao5�_e�/. 3ia -�6
LO
Gry, SmteZlPCOde County
Pn'marypropuryownerwnmctname E�mail
Under penaities of perjury, l hereby certify that this Sales Disclosure, ro the best of my knowledge and belief, is trve, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act". (Note:
Spouse info tionrSocia� Security and Driver's License/Othe� numbers are no[ necessary if no Homestead Deduction is
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