HomeMy WebLinkAboutHomestead_Bullington H. PREPARER -
Preparer of the Sales Disclosure Form Title
Lana Harper Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
5231 Oak Grove Road,Suite A,Evansville, IN 47715
I. SELLER(S)FGRANTOR(S)
Seller 1-Name as it appears on conveyance document
Marquise Enterprise,LLC Seller 2-Name as appears on conveyance document
Address(number and street) i- "
y)-e i•e .4i ,.y!_:-� 1,,..- :' ,{"-, Address(number and street)
7
City,state,and ZIP Code =
x ( '7 1 City,state,and 21P Code
Country Country
United States of America United States of America
E-mail address '
1
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 I .4 1-5.5.A person who knowingly and intentionally falsifies the value of transferred
rya,property,or omit5)or falsifies any information reqdired to be provided,commits a Level 5 felony.
nature of Seller - Signature of Seller
r 1 �_-
Printed Name of Seller j� _ ff Date signed m/ ( Printed Name of Seller Date signed(mm/dd/yyyy)
Marshane D.Bonapafite i I
1-
J. BUYERS)/GRANTEE(S)'-APPLICATIO F R ROPERTY TAX DEDUCTIONS- - APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as appears o v an do e
Kyle Bullington
Address(number and street) Address(number and street) g022
609 S.Seminary St FEB 0 9 L
City,state,and ZIP Code ! City,state,and ZIP Code
Princeton,IN 47670 tth".-.4 ai,-t' Ci. a-' -
Country Country GIBBON COUNTY u� FOR
United States of America United States of America
E-mail address
i
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 I YES NO CONDITION
El
El 0 1.Will this property be the buyer's primary residence? i ❑ 3. Homestead
[ 0 El 4. Solar Energy Heating or Cooling System
I 2.Does the buyer have a homestead to be vacated for 0 El 5.Wind Power Device
❑ H this residence?If yes, provide address: 0 El 6. Hydroelectric Power Device
Address(number and street) `❑ El 7.Ge-othermal Energy Heating or Cooling Device
City,state,and ZIP Code County I
Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number -