HomeMy WebLinkAboutHomestead_Purkiser II r........_____________ _., .7
Preparer of the Sates Disclosure Form Title
Milton Norman - — - _ _ Settlement ADent _ '
Company
Address (number and Street, City, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
I. SELLERS)/GRANTOR(S)
Seiler 1 -Name as it appears on conveyance document Seller 2 -Name as appears on conveyance document
Jeremy Alan Purkiser as Trustee of the Jeremy Alan Purkiser Revocable
Address (number and street) Address (number and street)
5592E 475 S14,6
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City, State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670 ^
i Country Country {{{"�//0�'
US
Email Address -_ --
of my knowledge and
S tie f, e, correct, and complete as
required by taw, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intenti _ ",s the value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
S ra re o f:- Signature of Seger ��O/�0 �
/' � v- '� _ _...)
,.'-+ ;Name of Seller Date Signed (mn y) Printed Name of Seller Date Signed (�)
Jeremy Alan Purkiser, Trustee /0 - Z. 2-
J. BUYER(S)IGRANTEE(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
Jackie Bruce Purkiser II
Address (number and street) Address (number and street)
701 S Gibson St.
City, State, and ZIP Code City. Slate, and ZIP Code
Princeton, IN 47670
Country Y - Country
US
C�
apply for certain deduct-ions. Identify all of those that apply:
S YES NO CONDITION YES NO CONDITION
1, Will this property be the buyer's primary 1E 0 3. Homestead
8 0 0 residence? 0 ® 4. Solar Energy Heating or Cooling System
1 2. Does the buyer have a homestead to be vacated 0 ® 5. Wind Power Device
`•,) 03" 0 O for this residence? If yes, provide address: 0 GO 6. Hydroelectric Power Device
i Address (number and street) O 1 0 MI 7. Geothermal Energy Heating or Cooling Device
City, State, and Code 44n_1D ty 2C - -° -. 0 6 ' 1 vu'000, q 0 -co
.7.ra‘-‘__.
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
C\I information, SSN/Driver's Licensed/a'Other Number Is necessary only If a Homestead Deduction Is being flied.) -