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HomeMy WebLinkAboutHomestead_Knelson H. PREPARER Preparer of the Sales Disclosure Form Title I , Milton Norman Settlement Agent Company —f Address (number and street, city, state, country, and ZIP Code) 25 NW Riverside Drive, Suite 310, Evansville, IN 47708 r I. SELLER(S)IGRANTOR(S) i Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveyance document Elliot Jacob Matheis _ Address (number and street) Address (number and street) 104 E Vine Street City, State, and ZIP Code City, State, and ZIP Code Fort Branch, IN 4764-8 _ ------H Country Country US Email Address Email Address Telephone Number Under penalties of perjury, I hereby certify 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 Intents Hy falsifies the value of transferred , real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony S%gnature of Seller a Signature of Selleritkti 4/‘e, ': (' ,,,,re‘ ,7 /1 . )-o• ab)-S dd! Printed Name of Seller (mm/ddlyyyy) Pnnted Name d Date Signed (mml yyyy) Elliot Jacob Matheis 4/0/1 J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTI9NS —IDENTt THAT APPLY. Buyer 1 - Name as it appears on conveyance document Buyer 2 - Namw-O are on conveyartve/document SO '\' Brandy Knelson ti �� Address (number and street) Address (number and stree 0i City, State, and ZIP Code . City, State, and ZIP Code �/To ,9 - —` Country - Country - 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 ` 4 fib.. .; 0 .1. Will this property be the buyers primary a 0 3. Homestead (ek. _� ® /residence? 0 Cif) 4. Solar Energy Heating lotCjo4114tera t t 2. Does the buyer have a homestead to be vacated 0 ( 5. Wind Power Device 0 `,.. for this residence? if yes, provide address: 0 ( 6. Hydroelectric Power Device Address (number and street) 0 (d 7. Geothermal Energy Heating or Cooling Device ' City, State, and ZIP Code County -0 11 _l , O LA — Ooo. 3 (2_ o2 Under penalties of perjury, i hereby certify thatthls Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete