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Homestead_Morrison (32)
i H. PREPARER Preparer of the Sales Disclosure Form Kris Coon Title Company Closing Agent 4600 Washington Ave., Suite 102, Evansville, IN 47714 I SELLER(S)/GRANTOR(S} Seller 1—Name as it appears on conveyance document .` Derek Alexander Loomis Seller2—Name as appe F .n,%n once document c-dares.. q) I� l 0Address(number and street) y Sate,AndZIP`Co�d 1 At. It 1 v V L1•3( LI City,state,and ZIP Cod- O Country USA Country my knowledge and belie.,a- ( ) required by law,and is prepared in accordance with IC 6-1,1-5.5.A person who knowingly and intentionally fatlies the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. orrect and complete as 4 Signatur , Sellerr� / 1'C.��--- q�`_; Signature of Seller Printed ame of Seller s g -. (m day yy) Printed Name of Seller CJ j } Date signed(mm/dd/yyyy) Derek Alexander Loomis • 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 Patty Ann Morrison Address(number and street) Ron Morrison 530 S Stout St Address(number and street) r City,state,and ZIP Code Princeton IN 47670 City,state,an�Z de Country USA Country 0 3.Homestead residence? 0 L+3' 4.Solar Energy Heating or Cooling System 0 0 2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device for this residence?If yes,provide address: Address(number and street) 0 V 6,Hydroelectric Power Device 0 L` 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county 26-12-01-4n1i -000. 12G -0 2-8 Under penalties of perjury,I hereby certify that this Sates Disclosure,to the best of my knowledge and belief,Is true,correct and complete, ; . 0 .,1, y./°r 4r l H. PREPARER Preparer of the Sales Disclosure Form Title Kris Coon Closing Agent • Company E-mail address Telephone number Regional Land Title Company Kris@Regional-LT.com (612 )402-4553 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 conveyance document Address(number and street) Address(number and stree} City,state,and ZIP Code City,state,and ZIP Code � Country Country USA USA ✓U�1©�` .4) E-mail address Telephone number E-mail add - , ,,,A„ Telephone number ( ) dies _ ?f ( ) Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my kna 4t: 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 knowing' '*; n}igtaally falsifies the value of transferred real property,or omits or falsifies any Information required to be provided,commits a Level y Signature of Seller Signature of Seller ")(yv, coy?. OR Printed Name of Seller Date signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy) 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 Tylar Morrison Address(number and street) Address(number and street) 530 S Stout St City,state,and ZIP Code City,state,and ZIP Code Princeton IN 47670 Country Country USA USA E-mail address Telephone number E-mail address Telephone number (e12 )6772696 ( ) Pursuant to IC 6-1.1-12-44,the Sales Disdosure Form may be used to apply for certain deductions.Identify all of those that apply: YES NO CONDITION. YES NO CONDITION ❑ ❑ 1.Will this property be the buyer's primary ❑ 0 3. Homestead residence? 0 0 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device for this residence?If yes,provide address: 0 ❑ 6.Hydroelectric Power Device Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county 26-12-07- 4o'._o©o .129 -ozg 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/Dr er's Llcense/ID/Other Number Is necessary If a Homestead Deduction Is being tiled.) Signature oi. of 1 Signature of Buyer 2/Spouse 1, On M1 Printed Lege a Buyer 1 Sign atesF1� )r- Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY) Tylar Morrison '� Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number SSN: 4-0170 Page 3 of 0, 5