HomeMy WebLinkAboutHomestead_Richard (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Megan Boger Escrow Officer
Company E-mail address Telephone number
Foreman Watson Land Title mboger@fw-It.com (812) 909-4543
Address(number and street,city,stale,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as It appears on conveyance document Seller 2—Name as appears on conveyance document
Clarence J. Hopf,Jr. Susan E. Hopf
Address(number and street) Address(number and street)
City,state,and ZIP Code City,state,and ZIP Code
Country CCountry
US
E-mail address Telephone number E-mail address Telephone number
chjoe6@gmall.com (610) 709-4451 sue.hopf@gmaii.com (812) 454-6498
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 Intentional{ 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 T/j
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Dal; signed(mm/dd/yyyy)
Clarence J. Hopf, Jr. 08/22/2022 Susan E. Hopf "9& 4' 4� 022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTI•:, - IDENTIPRA3oLL T - 410 Y
Buyer 1—Name as It appears on conveyance document Buyer 2—Name as it a•"k—rot convey r p docu
Gregary Richard Shanny Richard 4, f
Address(number and street) Address(number and street)
\ '
8433 Red Oak Drive 8433 Red Oak Drive Gp
City,state,and ZIP Code City,state,and ZIP Code O,Q
Bismarck, ND 58501 Bismarck, ND 58501
Country Country
US US
E-mail address Telephone number E-mail address Telephone number
naynayrichard47@gmail.com (406) 850-0258 indianainmyheart@gmail.com goo,850 07 2
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 YES NO CONDITION
1.Will this property be the buyer's primary 1 3. Homestead
CI O residence? p C) 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated D f 5.Wind Power Device
O for this residence? If yes,provide address: p C) 6. Hydroelectric Power Device
Address(number and street) 0 f 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county D a_ II
^Mr (00Q. 'Vd0-W' L4
Under penalties of perjury,I hereby certify that this Sates 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.(Note:Both spouse's
Information,SSN/Driver's License/ID/Other Number Is necessary If a Homestead Deduction Is being filed.)
Signature of Buyer 1 , Signatur 2/Spouse
�
MMMMMM � ��
Printed L a a of Buyer 1 Sign Date( M/DD/YY) Pri ' egal Name of Buyer 2/Spouse Sign ate MM/DD/YY)
Gregary Richard 08/22/2022 Shanny Richard 08/22/2022
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Last 5 of SSN: 20(gig Last 5 of SSN: Igo Go
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H. PREPARER
Preparer of the Sales Disclosure Form Title
Megan Boger Escrow Officer
Company E-mail address Telephone number
Foreman Watson Land Title mboger@fw-lt.com (812 ) 909-4543
Address(number and street,city,state, country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Clarence J. Hopf,Jr. Susan E. Hopf
Address(number end street) Addre�Sber arld.street
/'D9 )Oa AS !� a `ill C-f
Cit�/� S�/ iCod/ �� r� cam an (I Code rt �� ��
Country Country
3 7
US US
E-mail address Telephone number E-mail address Telephone number
chjoe6@gmail.com (610) 709-4451 sue.hopf@gmail.com (812) 454-6498
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 b- ,and is prep led in accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifies the value of transferred
real prop or o is o f 1 any Information required to be provided,commits a Level 5 felony.
Pignatu „111, S le Signature of eller
rinted ame of S er Date signed(mm/dd/yyyy) Printed Name of Seller Da signed(mm/dd/yyyy)
I rence J. Hopf, Jr. 08/22/2022 Susan E. Hopf �2/2022
Ca p ,
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
Gregary Richard Shanny Richard
Address(number and street) Address(number and street)
8433 Red Oak Drive 8433 Red Oak Drive
City,state,and ZIP Code City,state,and ZIP Code
Bismarck, ND 58501 Bismarck, ND 58501
Country Country
US US
E-mail address Telephone number E-mail address Telephone number
naynayrichard47@gmail.com (406) 850-0258 indianainmyheart@gmail.com h )
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify o ti e at apply:
YES NO CONDITION YES/ NO CONDITION
o O 1.Will this property be the buyer's primary G \yam,/ O 3. Homestead ,q
residence? O p 4. Solar Ene�r Heati g'o, oling - -40
2. Does the buyer have a homestead to be vacated 0 O 5.Wind P a6 s.9 ice re7eae
-� O O for this residence? If yes, provide address: O CD 6. Hydroelectric(" t f l vice
Address(number and street) O CC��
0 O 7.Geothermal Energ� S_ or Cooling Devic
q4, .
City,state,ZIP code,and county 'VT i
Under penalties of perjury,I hereby certify that 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.(Note:Both spouse's
information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
Signature of Buyer 1 gnature of Buyer 2/Spouse
OL
Printed Legal Name of Buyer 1 Sign Date(MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY)
Gregary Richard 08/22/2022 Shanny Richard 08/22/2022
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Last 5 of SSN t Last 5 of SSN: Ej
Page 3 of 5
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