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HomeMy WebLinkAboutHomestead_Hermann H. PREPARER Preparer of the Sales Disclosure Form Title Christa D. Tracey Escrow Officer Company Address (number and street, city, state, country, and ZIP code) 605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 I. SELLER(S)/GRANTOR(S) Seller 1 - Name as it appears on conveyance document Seller 2 - Name as it appears on conveyance document Mark A. Kast Jaime A. Kast Address (number and street) Address (number and street) 313 S West St. 313 S West St. City, State and ZIP Code City, State and ZIP Code Haubstadt, IN 47639 Haubstadt, IN 47639 Country Country United States of America United States of America Email Address - 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 intentionally falsifies the value of transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. Signature of eller Spire of Seller s��Ak a. °I; atee- 1 Printed Name of Seller Date Signed (mmiddiName of Seller Date Signed (mm/dd/yyyy) Mark A. Kast YYYY) • Jaime A. Kast , jI -4-5- .. -5 it - 3- 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 onveyance document Samuel P. Hermann Elizabeth N. Hermann ,, . Address (number and street) Address (number and street) � ' I, 102 Ben St. 102 Ben St. q‘'''' e City. State and ZIP CodeCity, � State and ZIP die ,,,,,O Haubstadt, IN 47639 Haubstadt, IN 47: _ / Country Country �Oij,C �f United States of America United States of America O Q '71Email Address 4 - Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of tIt4e that apply: YcEvy NO CONDITION YES NO CONDITION ❑ 1 Will this property be the buyer's primary residence? V ❑ 3. Homestead ❑ 2. Does the buyer have a homestead to be vacated for O 14. Solar Energy Heating or Cooling System this residence? If yes, provide address: ❑ 5. Wind Power Device ‘;_ _ Hydroelectric Power Device ,' Address (number and street) ❑ Hydr o ❑ I .27. Geothermal Energy Heating or Cooling Device City, State, and ZIP Code I County f, (0 _ 2 - - - tAo - moo .rc--'r _ odmi 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/Driver's License//D/Other Number is necessary if a Homestead Deduction is being filed.)