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HomeMy WebLinkAboutHomestead_Russell (7) 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)/GRANTOR(S) Seller 1 -Name as it appears on copveyance document Seller 2-Name as appears on conveyance document Elizabeth M. Bttenopane�d-),-, 5f-1 Addj, sss(nn7umber,od stree Address(number and street) J:J ✓ ' it d...t���,r� �.� . City,statte,d Z, IP Code i City,state,and ZIP Code Country V 4 Country E-mail address 1„ ( ) F TILED Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is trC4or ub a lie mpiete 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. 6gn re of Ser ✓(f.�t� Signature of Seller �y _�Z�i �/� a) /GI'RS N COUNTY AUDITOF Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Elizabeth M.�nS0( ) 10/24/2022 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 Erina Leigh Russell William Thomas Russell Address(number and street) Address(number and street) 406 South Red Bank Road 210 Park Place W. City,state,and ZIP Code City,state,and ZIP Code Evansville, IN 47712 Cadiz, KY 42211 Country Country US US E-mail address YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary 00 3. Homestead O Li residence? O C) 4.Solar Energy Heating or Cooling System 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device O for this residence? If yes, provide address: 0 p 6. Hydroelectric Power Device Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county f0 —( —tg— l03-0Olf- go-) — org Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete Page 3 of 5