Loading...
Homestead_Adams 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 Ashley Marie Flowers Address(number and street) Address(number and street) 204 S West St. City,State and ZIP Code City, State and ZIP Code -414 Patoka, IN 47666 1 . . Country Country United States of America Fe i '��. Email Address Email Address 08?j?,Telephone Number Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief?ie ueaorre ,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 ����YYq/luransferred r erty,or omits or falsifies any information required to be provided,commits a Level 5 felony. ,- ' T Signature of Selle r I A C3�\ Signature of Seller OR 0.--)\ Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Sign (m d/yyyy) Ashley Marie Flowers YYYY) 11/26/2024 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 Thomas Adams Address(number and street) Address(number and street) 204 S West St. City, State and ZIP Code City, State and ZIP Code Patoka, IN 47666 Country Country United States of America Email 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 i'. a YES NO CONDITION YES NO CONDITION '=•,.; op El 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead 41-P 0 i 2. Does the buyer have a homestead to be vacated for 0 El 4. Solar Energy Heating or Cooling Syste this residence? If yes, provide address: 0 El 5. Wind Power Device Address(number and street) 0 0 6. Hydroelectric Power Device 0 © 7. Geothermal Energy Heating or Cooling Device City, State,and ZIP Code County ) )-o4 - Z'_-101 000. LIOLI- 020 Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,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.(Note:Both spouse's information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) Page 3