HomeMy WebLinkAboutHomestead_Johnson (25) H. PREPARER
Preparer)off the�S�ales�Dilsclosure Form Title
}i _�(eS/A-Lw Aft Title Company --�
1 Company �_ - -
I Address(number and street.city,state,country.and 21P Code)
yi 7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I.SELLER(S)IGRANTOR(S)
JI Seller 1-Name as it appears on conveyance document l Seller 2,II-Name as appears on conveyance document �"�,,
{ Estate of Patricia E.Nurrenbem,deceased;Subject to the rights of Key (S fQ/t--o f�a a E Nur✓ /i�vt• Suyj /i Wt1 A
Address(number and street) Address,`(numb/Jgr and street) d (J r r yW l.�y(/ S
207 Roosevelt Drive �- Zte. CvDCo_✓_t/f L)✓
City,state,and ZIP Code City.state.and ZIP Code
t Princeton,IN 47670 7�y( PLJ *-7(,76
Country Country
i US i uS
II 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
i real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
iliotr,wture of Seller I Signature of Seiler _ �r
I amK�er Date signed(mm/dd/yyyj tlpl 4nieO Name of Se C Date signed(mm/dd+�ry
Kevin Kruse,Co-Personal RepresentatN 64/88fP8.22- 1 /�JJ p y �C-17 Z z[ 4{?�2Z LPr,-Qner��p 145 r n-/ClSanol [/
I J. BUYER(S))GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALLw AT APPLY
I Buyer 1-Name as it appears on conveyance document ance document
I Blake A.JohnsonI L E D
Addresss Buyer 2-Name as it appears on
(number and street) Address(number and street)
f 8920 W 400 S
City.
state.alle, nd
ZIP
476 Code
City,state.and ZIP Code APR 1 2 2022 _
5
I-Country Country !��__—
i US //L4cft4..G1 a. t.7`k,r14-/
IE-
for certain deductions.Identify all of those that apply:
YES NO CONDITION ( YES NO CONDITION
3
1 ® 0 i.Will this property be the buyer's primary ID 0 3.Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
I O 2.Does the buyer have a homestead to be vacated ! 0 CX 5.Wind Power Device
1 for this residence?if yes,provide address: _ O ® 6.Hydroelectric Power Device
Address(number and street) 0 CX 7.Geothermal Energy Heating or Cooling Device
i City,state.ZIP code,and county 1
2OS
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of knowledge ^Obelief,�is tars.,correct,^—��my and and complete
of 5
copy