HomeMy WebLinkAboutHomestead_DeVasier H. PREPARER
Preparer of the Sales Disclosure Form Title
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Company Email Address Telephone Number
Address (number and street, city, state, country, and ZIP Code) �>
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I. SELLERS)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document Seller 2 — Name as appears on conveyance document
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Address (number and str ) CO dress (number and street)
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City, State, and ZIP Code , to IP Code
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Email Address Telephone Number Email Address fi: Telephone Number
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nder penalties of perj , 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.
Signal re of Seller Signature of Seller
Printed Name of Sell i / Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
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J. c10 BUYERS)/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 on conveyance document
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Address (number and street) Address (number and street) FILED
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City, State, and ZIP Codb City, State, and ZIP Code
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Country Country
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Email Address Telephone Number Email Address h ne Number
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LDdTOR
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 ,
d 0 .1. Will this property be the buyer's primary '
D 3. Homestead
residence 0 0 4. Solar Energy Heating or Cooling System
0 2. Does the buyer have a homestead to be vacated 0 0 5. Wind Power Device
for this residence? If yes, provide address: 0 0 6. Hydroelectric Power Device
Address (number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
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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/1D/Other Number is necessary only if a Homestead Deduction is being filed.) —
Signatures''' Buy r 1 ,. Signature of Buyer 2/Spouse
Printe Legal Name of Buyer 1 Sign Dat (MM/ D/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY'
Last Digi; f uyer 1 SSN/Driver's License/ID/Other umb d Last 5 Digits of Buyer 2/Spouse SSN/Drivers License/ID/Other Number
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