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HomeMy WebLinkAboutHomestead_Naas H. PREPARER Preparer of the Sales Disclosure Form Title Micah Scott Escrow Officer Company Address(number and street,city,state,country,and ZIP Code) 7412 Eagle Crest Blvd. Evansville, IN 47715 I. SELLER(S)/GRANTER(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Sherri Folsom AddrQgs(qumbEand�tr (J! w ^f - /2* Address(number and street) City,(tsltta►tte11,.�ro ri CUoB`Y zwic/�lJt ` (1 City,state,and ZIP Code Country 1 N=��� I k v Country E-mail address 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. Signature of Seller Signature of Seller e5-2,-VVii,;,_ & Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Sherri Folsom 06/17/2022 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 Sandra D. Naas Pamela K. Payne Address(number and street) Address(number and street) 2703 West State Road 68 2703 West State Road 68 City,state,and ZIP Code City,state,and ZIP Code Haubstadt Indiana 47639 Haubstadt Indiana 47639 Country Country US 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 a • YES NO CONDITION YES NO CONDITION Irk1 O H O O 1.Will this property be the buyer's primary CI 0 3. Homestead N o ›- residence? o 0 O 4.Solar Energy Heating or Cooling N r 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device 'z '� 0 for this residence? If yes,provide address: p l 6. Hydroelectric Power Device z o U Address(number and street) 0 C) 7.Geothermal Energy Heating or C ling evican zo City,state,ZIP code,and county m Page 3 of 5 r' i r) ''