HomeMy WebLinkAboutHomestead_Davidson (7) H. PREPARER • Title
Preparer of the Sales Disclosure Form Title Administrator
DianamRich
Hometown Title,LLC
Address(number and street,city,state,country,and ZIP Code)
20 NW First Street,Suite 100,Evansville.IN 47708 L
1.SELLERmeas it ANears on -
Selfer 1—Name as It appears on conveyance document Seller 2—Name as appears on conveyance
DLG Properties,LLC Address(number and street) _
Address(number and,strae� r t ti
8792 West 350 South , n ,
City,state,and ZIP Code City,state,and ZIP Code
Owensvllle, IN 47865
Country
Country USA G/gSOM e „Q ,d�"„_`v n
USAT� J
E-mall address
required to b provided,can who knowingly
nglyits a al 5 falo�nytionally falsifies the value of transferred
Signature of Seller\ Signature of Sailer
signed( m/dd/yyyy) Printed Name of Seller ( Date signed(mm/dd/yyyy)
Pri Name of Seller Data e 3 Il
Darrin Gottman 7- 7 I e.
J. BUYER(S)/GRANTEE(S)—APPUCAIION FOR PROPERTY BTAX DEuyer 2—IDUCame sOI S—IDEonNTIFY
n ALL
LT Adoc T APPLY
Buyer 1—Name as it appears on conveyance document
Timothy Davidson ��
Address(number and street) Address(number and street)
. .:_ . . So F S�h�C2
A / City,state,and ZIP Code
City,state,and ZIP Code 1 i h C e-�6 jV IN
NO CONDITION
be the buyer's rime 0 ❑ 3.Homestead
0 ❑ r. ide this property Y primary ❑ ❑ 4.Solar Enemy Heating or Cooling System
residence?
IV
❑ ❑ 5.Wind Power Device
❑ f2o Does the buyer if yea rovidehomestead to bes: vacated ❑ O 6 Hydroelectric Power Device
for this residence?If yes,provide address:
a(nu r a )' A V 0 0 T.Geothermal Energy Heating or Cooling Device
tuakZ ` etL yr� ynnll a6 - 12-01- -2o? -O01 Oil-023
Under ps of perjury.I herebyspared certify In accordance that this Sales Disclosure,to the beat of my knowledge end beuef.Is true,correct end complete
as required by law.and Is prepared/n aWordance with IC 5-1.1.5-5.A person who knowingly end Intentionally falsifies the value
of
CO
` pN,