HomeMy WebLinkAboutHomestead_Hagen H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Kevin L. Falls Regina G. Falls
Address(number and street) Address(number and street)
1502 S 1050 E 1502 S 1050 E
City, State and ZIP Code City, State and ZIP Code
Oakland City, IN 47660 Oakland City, IN 47660
Country Country
United States of America United States of America
E-mail address
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 provided,commits a Level 5 felony.
Si n re of WI Signature Seller ��
/tvata [l,,� ✓ ,ems._`-A---�2
P anted Name of eller Date signed(mm/dd/yyyy) Printed am of Seller Date signed(mm/dd/yyyy)
Kevin L. Falls 14...5 • ova- Regina G. Falls I
'L- ;7q-o2V-
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
Amanda M. Hagen
Address(number and street) Address(number and street)
114 E. Center Dr. FILED
City, State and ZIP Code City, State and ZIP Code
Oakland City, IN 47660 MAY 0 6 2022
Country Country ,/
United States of America Q Yv
to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES O CONDITION
0 1. ill this property be the buyer's primary residence? 4 . Homestead
❑ 5 ¢. Solar Energy Heating or Cooling System
0 Q� 2. Does the buyer have a homestead to be vacated for ❑ I /5 W d Power Device
this residence? If yes, provide address: j
El f9/ ydroelectric Power Device
Address(number and street) 0 El7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county 2& - 15`
4- c,3- -")co
C 0 py