HomeMy WebLinkAboutHomestead_Cagle H. PREPARER
Preparer of the Sales Disclosure Form Title
( � Christina Gourley Title Clerk
ompany
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance do
John Jones Crystal Jones corum
�4c)dress number a d street) ) i J
�( ( Addres (number an teat
;�.11 W►1 I by,/brr l�Tb r. C � �e 0 - F"�
ate,and ZIP Code City,st te,and ZI ode
rl f^c��vy� 1 N ��(D� z
Country , ` Count C N_ MI
Pi
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 wh knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided o mits a Level 5 felony.
Signet f Seller gna a of S le
2"---
/i
Printed Na of Seller 1 Date signed(mm/dd/yyyy) Pr" ted me of Seller Date si ne mm/dd/yyyy)
John Jones 7 — I/—Z Crystal Jones l � )/0�
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
Christopher A. Cagle
dress(number and street) Address(number and street)
Ll go tt/ s-4{J._ Si
city,liate,�! ant ZIP Code City,state,and ZIP Code
r�nc. on =Lid/ 4/ 7670
Count)s1(:_ Country
apply for ce deductions.Identify all of those that ajr: tit
tA
YES 0 CONDITION YES O CONDITION
O 1.wll this property be the buyer's primary 0 3. Homestead ,�
1:0‘.5".-
reside O CI 4. Solar Energy Heating or Cooling Soh
Does the buyer have a homestead to be vacated 0 CI 5.Wind Power Device
for this residence? If yes, provide address: 0 C) 6.Hydroelectric Power Device
r Address(number b\and street)Slri �, 0 p 7.Geothermal Energy Heating or Cooling Device
4 SOri- Ci sate,ZIP code,and county
' - ten- \. - boo 6-I1-06 - 4°2---O0 L-\-3s+-02S
8` Under penalties of perjury,I hereby certify that this Sales Disclosure,to he best of my knowledge and belief,is true,correct and complete
N) 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
O transferred real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.(Note:Both spouse's
information,SSN/Dr/ver's License/ID/Other Number is necessary if a Homestead Deduction Is being filed.)
>Sgnatura oL8ayer 1 Signature of Buyer 2/Spouse
P Legal Name of Buyer 1 Sign Dale�(MrW8D/)!Y) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY)
.o� Christopher A. Cagle tr-j_ I ?JJ``
c4 Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
8-9926
\•/"