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HomeMy WebLinkAboutHomestead_Sysol H. PREPARER Preparer of the Sales Disclosure Form Title Christa D.Tracey 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 Jodi C. Luttrull Kevin W. Luttrull Address(number and street) Address(number and street) 2678 W. Julie Dr. 2678 W. Julie Dr. 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 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. Signature of Selle� jf, Signature of Seller ,Q sr ` � �✓ Date signed mm/dd/ ^Printed Name of Se Date signed(mm/dd/yyyy) Printe'U Name of Seller I 9 ( yyyy) Jodi C. Luttrull 4,2_/L1'. .,)- Kevin W. Luttrull id -t q- a-Q-__ 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 Paul Sysol Address (num er and street) �� Address(number and street) �, o tl " ikV� City, State and ZIP Code y City, Sta and IP Code \ T ,,r— IN Country Country F„am.i LLaJ I v United States of America _ o E-mail address Pursua o IC 6-1.1-12-44,the Sales Disclosure Form may be used to appl for certain deductions.Identify all of those that apply: YES NO CONDITI YE NO CONDITION ❑ 1. Wil is property be the buyer's primary residence? ❑/1. Homestead ❑ O 4 Solar Energy Heating or Cooling System 0 lQ 2. oes the buyer have a homestead to be vacated for 0 Wind Power Device is residence? If yes, provide address: ❑ [0../6"-.. droelectric Power Device Address(number and street) El ❑ Geothermal Energy Heating or Cooling Device City,State,ZIP code, and county / la-(/93' 9S.2-02 / 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 3 C OFIN( 1