HomeMy WebLinkAboutHomestead_Price H. PREPARER
Preparer of the Sales Disclosure Form Title
Shelby Head Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on c vey c doc nt
Derek Shane Abner
Address number and street Address number and street)
w S P S 289
City,State,and ZIP Code City,State,and ZIP C.•- Q
7 L(LiPA �N - 7 G `/0 Country G4s,
\Jsie,
c„Ny
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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
Printe ame of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller 1 Date Signed(mm/dd/yyyy)
Derek Shane Abner July 18, 2023 July 18, 2023
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
Chad E. Price
Address(number and street) Address(number and street)
702 South Seminary Street
City,State,and ZIP Code City,State,and ZIP Code
Princeton, IN 47670
Country Country
USA
E-mail PO17 Telephone Number
Pursuant to IC 6-1.1-12.44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary 0 ❑ 3. Homestead
❑ residence? ❑ 0 4.Solar Energy Heating or Cooling System
rg.tj 2. Does the buyer have a homestead to be vacated ❑ ❑X 5.Wind Power Device
El L_3 for this residence? If yes, provide address: ❑ D 6. Hydroelectric Power Device
Address(number and street) ❑ 0 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
6-‘2-01-(Ad3 - 001.55 7 02)3
-
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
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