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HomeMy WebLinkAboutHomestead_Rascher H. PREPARER Preparer of the Sales Disclosure Form Title Matthew Jarvis 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 Sabre Investments, LLC Address (number and street) Address (number and street) 31 Homewood Dr, PO Box 3074 City, State and ZIP Code City, State and ZIP Code Carbondale, IL 62902 Country Country United States of America Email Address Under penalties of perjury. I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, dzsEiit, p.m c-i: • ete 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 tr�nAfe •.�. &eal property, or omits or falsifies any information required to be provided, commits a Level 5 felony. .,_ii -r r Signature of Seller ----' Signature of Seller /2zr_' d4r. GIBSONPanted Name of Seller Date Signed (mm �p/dd/ Printed Name of Seller V _iv lo�t®� 0 -: : (mm/dd/yyyy) Kenny Rochman, Manager YYYY) R 11 > , J. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY AX DEDUCTIONS - IDENTIFY ALL THAT APPLY Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance document Heather R. Rascher Tracy E. Rascher Address (number and street) Address (number and street) 416 S White Church Rd 416 S White Church Rd 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 YES NO CONDITION YES NO CONDITION 11;1 ❑ 1. Will this property be the buyer's primary residence? 2 0 3. Homestead ❑ ❑ 2. Does the buyer have a homestead to be vacated for ❑ El 4. Solar Energy Heating or Cooling System this residence? If yes, provide address: ❑ 0 5. Wind Power Device Address (number and street) ❑ 2 6. Hydroelectric Power Device ❑ El 7. Geothermal Energy Heating or Cooling Device City, State, and ZIP Code County / / ploa l F / ! Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, co t, and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifi a valu of transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both ots 's infor ation, SSN/Driver's License/1 Other Number i ecessary if a Homestead Deduction is being filed.) ' Page 3 • NTRA-CT5 ter.". 4 ;� .,