No preview available
Homestead_Clark (4) 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., ^veyance document Brandon L. Deputy Address(number and street) Address(number and street) 11105 E Lincoln Heights Rd 144 City, State and ZIP Code City, State and ZIP Code Z/eC Oakland City, IN 47660 ap /f Country Country c/ c„. 4z 04 United States of America 04, Email Address .4/7 Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,corn nd 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 o ransferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. \ ignature of Seller d, Signature of Seller Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed(mm/dd/yyyy) Brandon L. Deputy yyyy) 12/3/2024 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 Hallie J.Clark Address(number and street) Address (number and street) 422 W Trusler St City, State and ZIP Code City, State and ZIP Code Oakland City, IN 47660 Country Country United States of America Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those to } ` YES NO CONDITION YES NO CONDITION -" K<<... sy , El4)„.. ❑ 1. Will this property be the buyer's primary residence? El ❑ 3. Homestead , 0 72. Does the buyer have a homestead to be vacated for 0 El 4. Solar Energy Heating or Cooling S tern this residence? If yes, provide address: 0 El 5. Wind Power Device 0 El 6. Hydroelectric Power Device Address(number and street) 0 © 7. Geothermal Energy Heating or Cooling Device City, State,and ZIP Code County a(' -13_I 1 _ 0, —O 0 0. 5 L13 — O C 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.) 3