Loading...
Homestead_Payne (4) H. PREPARER Preparer of the Sales Disclosure Form Title Abbigail Moers 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 cony a document Secretary Of Housing And Urban Development HUD Case No.156-390451 Address(number and street) Address(number and street) 40 Marietta St 4/3p City,State and ZIP Code City,State and ZIP Co <").D Atlanta,GA 30303 \J Country Country /e6, United States of America �GQ/ E-mail address ` of my knowledge and belief, is truecorrect 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 Seller Signature of Seller Printed Name. of Seller Patti signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy) HUD ya ValkAtVI0.1A �y ulZftc,,tr 04/07/2023 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY Buyer 1 — street) Address(number and street) 80 W. 800 S.,Apt 5301 City,State and ZIP Code City,State and ZIP Code Fort Branch, IN 47648 Country Country United States of America apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION : El 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead 0 El 4. Solar Energy Heating or Coolin y 0 El 2. Does the buyer have a homestead to be vacated for this ❑ 5. Wind Power Device "'"Y .`•' sir r, © residence? If yes, provide address: 0 El 6. Hydroelectric Power Device Address(number and street) 0 RI 7. Geothermal Energy Heating or Cooling Device City,State,ZIP code,and county 06 —1- 39— /PO boy. 5c) -dt Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete