HomeMy WebLinkAboutHomestead_Price (5) H. PREPARER
Preparer of the Sales Disclosure Form , Title
Kelly Norton I Escrow Officer li
Company ;
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, 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
BRYAN J.ARCHIBALD
Address(number and street) Address(number and street)
1507 Breezy Creek Dr
City,state,and ZIP Code City,state,and ZIP Code
Evansville, IN 47720-7445
Country Country
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.
gnat of Seller f Signature of Seller
rim ed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
BRYAN J.ARCHIBALD December 17, 2021 December 17, 2021
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
DAELAINEY PRICE
Address(number and street) Address(number and street)
1501 S Washington Ave
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-2939
Country Country
E-mail address
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 IV
CONDITION YES O CONDITION
co
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? ❑ tj
�/4.Solar Energy Heating or Cooling Sy Co N H
{1 - �c)<�HYE 5.Wind Power Device
11 vv�� homestead to be vacated ❑ no
❑ for this residence? If yes, provide address: 0 �6.Hydroelectric Power Device NMI
p a
Address(number and street) 0 7.Geothermal Energy Heating or Cool ice
0
City,state,and ZIP Code County m
26-12-18-301-003.026-028 c->
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