Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Homestead_Bolin
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 Household Thoughts, L.L.C., an Indiana limited liability company Address(number and street) Address (number and street) 10890 S. US Hwy 41 City, State and ZIP Code City, State and ZIP Code Haubstadt, IN 47639 , Country Country United States of America Email Address Address Telephone Number Under penalties of perjury,I hereby certify 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. Signature of Seller Signature of Seller .J Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Da ;. ry ed (mm/dd/yyyy) Brian S. Ellis, Managing Member YYYY) "', 12/13/2024 -' J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY ..,0,ilio 0.... Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on e. v -nce document James Bolin Sara Bolin Address(number and street) Address (number an. ;r t) 1407 N Cherry St. 1407 N Cherry S ©,L� City, State and ZIP Code City, State and ZIP��.ode fl`L Mount Carmel, IL 62863 Mount Carmel, IL 62863 c,Z Country Country 'y�vO��Ov' United States of America United States of America �N,c.t P '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 r El 0 1. Will this property be the buyer's primary residence? El3. Homestead 2. Does the buyer have a homestead to be vacated for ❑ El 4. Solar Energy Heating or Cooling System this residence? If yes, provide address: ❑ El 5. Wind Power Device Address(number and street) 0 El6. Hydroelectric Power Device 3 E U I4 6 E 13A6E ROAD 0 El 7. Geothermal Energy Heating or Cooling Device I City, State, and ZIP Code County -OA KLAND GTTY, J y 760 GERS©N ,c -1 i- 19-a o�-00 .Lo`l- - (0 7 I 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 spouses information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) >