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HomeMy WebLinkAboutHomestead_Taylor (9) H. PREPARER Preparer of the Sales Disclosure Form Title Hunter D Crays Closer E-mail address Dubois County Title Address(number and street,city,state,country,and ZIP Code) 606 Main St. Jasper, IN 47546 I. SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on c nce document Pauline L.Crawford (/ Address(number and street),`/�'� Address(number and street) 4.4:0 ,Y t e IV . e ` City,state,and ZIP Code ✓qN q oy,state,and nZIP ode yA r oy.'7 E J j .Gb+ unt t/ I 1� /V "7 [(f Country Gi-Q, _`� 2p240 CounCry `rON CO U � Om 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 providd,co Signature its ot a Level 5 felony. Alr gna r1 , (r -\ 1 t=si Printed Name of Seller Date signed(mm/dd/yyyy) ''rint-• Name of Seller\I\ i` �I Date-te signed(mmidd/yyyy) 1-- line L. Crawford I01/24/2022 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY B AX DEDUCTIONS s it ap—IDEars NTIFY n Q ante THAT docu APPLY ent Buyer 1-Name as it appears on conveyance document Haleyr S.Taylor Jacob Taylor Address(number and street) Address(number and street) li 1? 5• /111 ct,„ 51 same City,state,and ZIP Code City,state,and ZIP Code oW r°„5 tr;l Ai)1 I , '1 7 b6 r Country 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: YES NO CONDITION YE / NO CONDITION �r (] 3.Homestead 1.Will this property be the buyer's primary residence? 0 ill 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 '5.Wind Power Device for this residence?If yes,provide address: O Hydroelectric Power Device Ad s er an street) 0 t/"7.Geothermal Energy Heating or Cooling Device / rta� l I(S Cty,state,ZIP code,and county 1 T —`Z—ZQ 1,,� 1�� -2-4—d 7 2 �tpincf e / � �`` `a Un er penalties of perjury,I hereby certify that 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 Levet 5 felony.(Note:Both spouse's information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) Page 3 of 5