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HomeMy WebLinkAboutHomestead_Holzmeyer f H. PREPARER Preparer of the Sales Disclosure Form Title Sarah McDanie's Escrow Officer Company Address (number and street, city, state, country, and ZIP Code) 7412 Eagle Crest Blvd Evansville, IN 47715 I. SELLER(S)/GRANTOR(S) Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears a nce Ee Cedrick B. Hancock Charlotte L. Hancock Addr s (number end sire ) /1 i _ Address rrier and street} Tatrid �u �025C' sat LIPC 9 t e, and ode ,, r ���/� City, state, and ZIP Cole . U�64sU,�. f V ' ) Country Country US US �Jz , - c' a. ,Uraz 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, comml s a evel 5 fe ny. S g ure f tierfr3.. 46 cikk. ' Signalur Her _/ ' C "‹ ( /1001121 Printed Name of Seller Dale signed (mm/ddty yyy) Printed Nme o elder f ' Date signed (mrn/dd/yyyy) Cedrick B. Hancock 11/12/2025 Charlotte L. Hancock 11/12/2025 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 Nathenlal A. Holzmeyer Alese A. Holzmeyer Address (number and street) Address (number and street) 3761 North 175 West 3761 North 175 West City, state, and ZIP Code City, state, and ZIP Code Patoka, IN 47666 Patoka, IN 47666 Country Country US US 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 1. Will this property be the buyer's primary D E) 3. Homestead 0 O residence? 0 O 4. Solar Energy Heating or Cooing System 2. Does the buyer have a homestead to be vacated 0 O 5. Wind Power Device for this residence? if yes, provide address: O O 6. Hydroelectric Power Device Address (number and street) 0 [] 7. Geothermal Energy Heating or Cooling Device City, state, ZIP code, and county 4 �� 1 ) 1 O 0 _0 0 LI • O G ;1 — O z . Under penalties of perjury, I hereby certify that this Safes 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 orfalsIffes any information required to be provided, commits a Level 5 felony. (Note: Both spouse's - Page 3 of 5 010141 ' 10.: y