HomeMy WebLinkAboutHomestead_Gooch (3) H. PREPARER
Preparer of the Sales Disclosure Form Title tt {
1` 1 t i CIor-"e- tt`e.mot U-k- �tz-tw
Company
Address(number and street,city,state,country,and ZIP Code)
20 NW 1st Street,Suite 100,Evansville,IN 47708
1.SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Cherie M.Kidd PI
Address(number and street) Address(number and street) T
118 W Pine Street
City,state,and ZIP Code City.state,and ZIP Code D
Princeton,IN 47670
Country Country 4•uee 1
US +--
E-mail address
to the beat of my knowledge and belief,is true, ,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 Kits of transferred
real property,or omits or falsifies any Inform on required to be provided,commits a Level 5 felony.
$tgrta) it / ter i/1 - Signature of Seller
I ` /t
Printed Name of Seller Date signed(mnYddlyyyy) Printed Name of Seller Date signed(mm/d.d/yyyy)
Cherie M.Kidd 12/02/2022 12/02/2022
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
Kimberly A.Gooch
Address(number and street) Address(number and street)
996 S Old State Road 65
City.state.and ZIP Code City.state.and ZIP Code
Princeton,IN 47670
Country Gauntry
US
E-mail address
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 IN
0 3. Homestead
residence? 0 (Z\ 4.Solar Energy Heating or Cooling System
}4 2. Does the buyer have a homestead to be'v Ell
Vacated 0 � 5.Wind Power Device •
,`y for this residence? If yes,provide address: 0 A 6.Hydroelectric Power Device
Address(number and street) p 1 ) 7.Geothermal Energy Heating or Cooling Device
City.state.ZIP code,and county D b — 1') - r - -1()7 - n 01 . 1 1 Z y
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
of 5