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HomeMy WebLinkAboutHomestead_Michl H. PREPARER Preparer of the Sales Disclosure Form Title } Katie Felty Escrow Officer Company Address (number and street, city, state, country, and ZIP Code) 7412 Eagle Crest Blvd Evansville, IN 47715 I I, SELLERS)/GRANTOR(S) seller 1 - Name as 11 appears on conveyance document Seller 2 - Name as appears on eyance document Theresa L. Bradley Address (number and street) Address (number and street) 4 Tto 5 E 1 a-c-)0 '3ou Clt fate, arxi ZIP Code ~City, stale, and ZIP Code Se' `n`-)\- J �. 3`\ Country t Country P ?6 us Us 4QS best of my knowledge and bIL.,. • erred. and complete as required by law, and Is prepared In accordance with IC 6-1.1-5.5. A person who knowingly and intentiortall ' 'Il : .,. , value of transferred .real pr000rty, or omits or falsifies any information required to be provided, commits a Level 5 felony. Ofi. Sign t6rer of Seller A ` Signature of Seller hiti) r_4(.._.o.d. Yed Name oe l i to signed (mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Theresa L. Bradley •' 19/25 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 Karen M. Michl Gary Patrick Michl Address (numb r and street) Address b rx1 Street) " -ot--k i' (balue‘`,.\\, --- r .'% 4k-( (-14\1._ City, tale, and ZIP Code City, state, and ZIP Code t,ei k_ 1 'Pt- ''5 A 4-Ltr2 Country Country 1 US Jus O 1. VYII this property be the buyer's primary O O 3. Homestead residence? 0 O 4. Solar Energy Heating or Cooling System VO 2. Does the buyer have a homestead to be vacated 0 O 6. Wand Power Device for this residence? If yes, provide address. 0 0 6. Hydroelectric Power Device � Aairess (number a d stre 0 C) 7. Geothermal Energy Heating or Cooling Device A �t l i\A„, V •\\CL L(N. City late, ZIP code, and county A11V Lid- SS?- ; - 2 '3 - �- Zoo -to Oa 1 3 - 00c . Under penalties of perjury, Thereby certify that this Sales Disclosure, to the bast 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 8 felony. (Note: Both spouse's Page 3 of 5