HomeMy WebLinkAboutHomestead_Burgan H. PREPARER
Preparer of the Sales Disclosure Fonn Title
Jessica Bajaj Escrow Officer
Company
Address(number and street.city,state.country,and ZIP Code)
409 Main St.,Vincennes,IN 47591
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document
EquityPoint Fund II,LLC Seller 2-Name as appears on conveyance document
Address(number and street)
Address(number and street)
City,state,and ZIP Code
City,state,and ZIP Code
Country Country
United States of America United States of America I ,
E-mail address Telephone number E-mail address l Telephone number
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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 6-1.1.6.5.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 Leval 5 felony.
Signature of Seiler Signature of Seller
Printed Name of Seller Date signed(tar idd/yyyy) Printed Name of Seller Date signed(mm/dd/riyw)
Matt Buckets
J.BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTI
Buyer 1-Name as It appears on conveyance document Buyer 2-Name as appears on conveyance document
Seth D.Burgan Britta L.Burgan FEB 0 R 2022
Address(number and street) Address(number and street) t� �
703 N.Blain St 703 N.Blain St f here t tit" e'G. ..,f:.4.4....-.,...
City,state,and ZIP Code City.state.end ZIP Code GIBSON COUNTY AUDITOR
Princeton,IN 47670 Princeton,IN 47670
Country Country
United States of America United States of America
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to ap ly for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
I 0 3.Homestead
® 0 1.Will this property be the buyer's primary residence? 0 ® 4.Solar Energy Heating or Cooling System
❑ ® 2.Does the buyer have a homestead to be vacated for 0 05.Wind Power Device
this residence?If yes,provide address: 0 ® 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,slate.and ZIP Code County a 4 -` I - 01-20 2 0 0 1 . q 8 2 - d 23
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