HomeMy WebLinkAboutHomestead_Hall (3) H. PREPARER
Preparer of the Sales Disclosure Form Title
Milton Norman - -�� Settlement Agent
Company E-mall address
Address(number and street,city.state.country,and 2IP Code)
25 NW Riverside Drive,Suite 310,Evansville, IN 47708
I. SELLERS)/GRANTOR(S) _
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveya nt
Darick J.Davis
Address(number and street) Address(number and street)
102 Sweetgum Lane _
City,slate,and ZIP Code City.state,and ZIP Code �p
Marion, IL 62959
•
Country Country Gje6071, l??3
US
E-mail address
my knowledge and belief,is true,k —.4 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 =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
A r t , . y
Printed Name of Seller' Dat,_s'gned(rem/ ) Printed Name of Seder Date signed(mm/ddlyyyy)
Darick J.Davis r _
J. BUYER(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
Zacheriah L.Hall
Address(number and street) Address(number and street)
321 E. Oak St.
City,state,and ZIP Code ' City,state.and ZIP Code
Oakland City, IN 47660
Country Country
US
E-mail address
( )
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:
v s 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
e2.Does the buyer have a homestead to be vacated 0 CSS 5.Wind Power Device
for this residence? If yes,provide address: 0 [33 6.Hydroelectric Power Device
Address(number and street) 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
26 I g -do 2 - cop, .
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