HomeMy WebLinkAboutHomestead_McClellan (4) •
H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail Moers Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Jahau Vanlalhruaia Mary Zosangliani
Address(number and street) Address(number and street)
107 N. 3rd Ave. 107 N. 3rd Ave.
City,State and ZIP Code City,State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
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.
*nature of Se,�l4er +atur of Seller ``
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Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Jahau Vanlalhruaia 6/10/2022 Mary Zosangliani 16/10/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL TH PPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it ap r o o yance document
Eric McClellan Megan McClellan ��
Address(number and street) Address(number and street)
621 S. Hart St. 621 S. Hart St. f//I/City, State and ZIP Code City, State and ode 1 720?
Princeton, IN 47670 Princeton, ING4/ Z
Count Country N CO/A,2 1-Y���"
ry
United States of America United States of Americ TY,y e2,�.
E-mail address
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. S NO CONDITION YE NO CONDITION
� ❑ 1. Will this property be the buyer's primary residence? ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
�
❑ 2. Does the buyer have a homestead to be vacated for this ❑ 0 5. Wind Power Device
residence? If yes,provide address:
0 IZI 6. Hydroelectric Power Device
Address(number and street) ❑ ii 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county 02,112
/ --11
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