HomeMy WebLinkAboutHomestead_Toll H. PREPARER
Preparer of the Sales Disclosure Form Title
Katie Felty Escrow Officer
Company
Address (number and street, cry, state, country, and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as rt appears on conveyance document Seller 2 - Name as appears on ance document
Jason J. Miller Special Needs Trust dated October 21 , 2013
Address(number and street) Address (number and street)
1751 Robert Landis Road
City, stale,and ZIP Code City, slate, and ZIP Code
Greensburg KY 42743 JqN
Country Country c 2 (D
US US
�- �6'
beat of my knowledge and belle tr Qc ct nd complete as
required by law,and Is prepared in accordance with IC 6-1.1.5.6. A person who knowingly and intentionally fa alue of transferred
real property, or omits or falsifies any Information required to be provided, commits a Level 6 felony. ti
Signature of Seller Signature of Seller
Printed Name of Seller Date signed (mmlddlyyyy) Printed Name of Sever Date signed (mnVddtyyyy)
Selena S. Clark, Trustee
J. BUYER(S)/GRANTEE(S) --APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document I Buyer 2-Name as it appears on conveyance document
Patrick L. Toll Carle A. Tofu
Address (number end street) Address (number and street)
1219 Villa Drive 1219 Villa Drive
City, state, and ZfP Code City, state, and ZIP Code
Evansville IN 47711 Evansville 1N 47711
Country Country
US US
YES NO CONDITION YES NO CONDITION
1. Will this property be the buyer's primary O O 3. Homestead
0 0 residence?
O i=) 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated O O 5. Wind Power Device
for this residence? If yes, provide address- 0 6, Hydroelectric Power Device
Address (number and street) 0 p 7. Geothermal Energy Heating or Cooling Device
City, state. ZIP code, and county
^1) - 21 14°0 ' 001 .336 --024 -
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