Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Homestead_Barclay
H. PREPARER Preparer of the Sales Disclosure Farm Title Gabrielle Brooks Title Examiner Company Address(number and street;city,state,country,and ZIP Code) 25 NW Riverside Drive,Suite 310,Evansville IN 47708 I.SELLER(S)IGRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears onitel do nt Jennifer M.(Richter)Smitha ' 4t) Ad s rum ands t) 6„(-.. Address(number and street) M . .6.1„.„*.....„ Cirate,and ZIP Code City,state,and ZIP e CountryCountry r. S USA Coe.; :" E-mail address best of my knowledge and belief,Is true,co 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. gaaiure of ler Signature of Seller Print eN me of Seller Date signed(mm/ddyyyy) Printed Name of Seller Date signed(mm/ddtyyyy) Jenner .(Richter)Smitha 141-23 - - J. R(S)IGRANTEE(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 Jesse L.Barclay Robert T.Hoskin _ i.,, • Acitlress( umber�rtd s )ility) _s_f Address(nu aril g14.' //►u/ rCity, t ,and ZIP C� City,sta , IP Cw‘....e....:: s`, TT LI q Country Country USA 44 E-mail address for certain deductions.Identify all of those that apply: 0 YES NO CONDITION YES NO CONDITION 0— 1.Will this property be the buyer's primary 0 0 3. Homestead CT- El ❑ residence? ❑ f❑ 4.Solar Energy Heating or Cooling System M Z.Does the buyer have a homestead to be vacated 0 El 5.Wind Power Device g )( ❑ for this residence?If yes,provide address: ❑ ❑ 6.Hydroelectric Power Device 1ddr9nL1q3er ands ❑ ❑ 7.Geothermal Energy Heating or Cooling Device oca-t t 2S�o / °� Q n �Q / M City gtate,�IP mode,and county s ��6 6 0- ),C—I I —1 5 —3 O 1—d 0 o . 4 0 —Q2-b . l Under penalties of u y,,((III�'hereby certifybthat this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete .'T 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 N transferred real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.(Note:Both spouse's l � • Ok t;ivea 111. Cif 11 (��/at, Page 3 of 5 VAC... - -- "e—I�I rl�W WI I' bG tax v s c � ho�, s M� \`J 26-l3r-?�300 -no©. -ofl 6 • f Ai �r+ J M