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HomeMy WebLinkAboutHomestead_Tackett H. PREPARER Preparer of the Sales Disclosure Form Title Payge Marx Escrow Officer Company Address(number and street,city,state, country,and ZIP Code) 7412 Eagle Crest Blvd Evansville, IN 47715 I. SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Richard Thomas Jennifer Thomas Address_(numbejand street) Address(number and treet) GI .r �I So 9 4. 14 5I . City,state,and ZIP Code City,state,and ZIP Code (Ve5c3,.';ILL , -3-1, (a8d9 CYO s 54/ u i ' 1-- 6� ,39 Country Country US US E-mail addressA (812) 781-0075 nal eti s o e u I herebycertifythis Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as Under pe erjury, 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 iformation required to be provided,commits a Level 5 felony. Sio ature ofler Z S naturef Seller / rr ��_ • 1 d'Name of Seller Date signed(mm/dd/yyyy) inted a of Seller Date signed(mm/dd/yyyy) Richard Thomas 08/30/2023 Jennifer Thomas 08/30/2023 J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY HAP Buyer 1—Name as it a pears on conveyance document Buyer 2—Name as it appears on e n doc t er Steven Tackett ( Address(number and street) Address(number and street) 12537 South 40 West SEP 01 2073 City,state,and ZIP Code City,state,and ZIP Code Haubstadt, IN 47639 �n�� Country Country M� c2 J'V &n4J US US GIBSON COUNTY AUDITOR to apply for certain deductions.Identify all of those that apply: YES NO CONDITION / NO CONDITION 1.Will this property be the buyer's primary ( --n El 3. Homestead O O residence? O Q 4. Solar Energy Heating or Cooling Syste 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device O for this residence?If yes,provide address: O O 6. Hydroelectric Power Device Address(number and street) O Q 7. Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county 026 —7 7- .Z 9 -/oo - Oo (rt. 5/ S _Oct/ Last 5 of SSN: Page 3 of 5 C 0 P'Y