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HomeMy WebLinkAboutHomestead_Sagers H. PREPARER Preparer of the Sales Disclosure Form Title Kris Coon Closing Agent Company Address(number and street,city,state,country,and ZIP Code) 4600 Washington Ave., Suite 102, Evansville, IN 47714 I. SELLERS)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on convey ment William Brent Schafer �� 77 A drb6r_aqd at .\ O� �'�C Address(number and street) k:40 st e,@Pd,��Cgd@ , r ( City,state,and ZIP Code /yAp Country I`V �J �J Country �trr /8 q/25 USA USA 0 6),., E-mail address address ON�{� Telp'hone number Under penalties of perjury,I hereby certify this Saes Disclosure,to the best of my knowledge and belief,is true,19-. ; ' -.,' omplete as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies I •& 4.re of transferred real property,or omits or falsifies any required to be provided,commits a Level 5 felony. Signature gfpeller,.--7 G' --h Signature of Seller , Printed Name of Seller I Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) William Brent Schafer s ,:(-- 2—/ 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 Breean H. Moody Alexander C.Sagers Ad\r�sjnprib ran trit)� p PO � Address(number and sty et) City, ari hed ZIrP{•.. �' h )IQ[�0 0 City,state,and ZIP Code Country Country USA USA CONDITIONii, YES NO CONDITION 1.Will this property be the buyers primary 0 3.Homestead O residence? O V 4.Solar Energy Heating or Cooling System O Does the buyer have a homestead to be vacated 0 ( 5.Wind Power Device for this residence? If yes,provide address: 0 IY :Hydroelectric Power Device Address(number and street) 0 [13" 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county 1 '1-203 —00 © , SD ' ry 5 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 Page 3 of 5 .; - 0. ' '. 4' .t