HomeMy WebLinkAboutHomestead_Long (2) H. PREPARER
Preparer of the Sales Disclosure Forth 1 Title
Gwyn Shaw I 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)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as ap
pears on conveyance document
Larry R.Patterson Wanda F.Patterson
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City.state,and VP Code
1- 4 A L.-b S+.4 OI t f.,tv 1 / (P3 C City,stare,and ZIP Code
Country j �,artry, MAY 1 3 2022
United States of America United States of America
E-mall address
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 infomtatIon required to be provided,commits a Level 5 felony.
d � � Signature of Seller ,
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Printed Name d Sal Printed Named Sear Date signed
Larry R.Patterson Wanda F.Patterson c'irt -
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document
Ye Buyer 2-Name as appears on conveyance document
Tyler J.Long
Address(number end street) Address(number and street)
401 Swallowfield Drive
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
United States of America United States of America
E-mail address
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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
S.
Q 0 1.Will this property be the buyer's primary residence? ® 3.Homestead
0 ® 4.Solar Energy Heating or Cooling System
❑ 0 2.Does the buyer have a homestead to be vacated for 0 10 5.Wind Power Device
this residence?If yes,provide address: ❑ Q 6.Hydroelectric Power Device
Address(number and street) ❑ ® 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code county a t-r-2_--0 6 -- -00 3 °f s-- - O 2S
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