HomeMy WebLinkAboutHomestead_Diephuis IH. PREPARER
Proparer of the Sales Disclosure Form Title
Jill Gilillan Deed Specialist
Company Email Address
Address (number and street, city, state, country, and ZIP Code)
1349 Galleria Drive, Henderson, NV 89014
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2- Name as appearsrveyance document
r-PtKatie Renee McClanahan VV/ b,
Address (number and street) Address (number and street) " 12��
13 West Red Bank Road OS"
City, State, and ZIP Code City, State, and ZIP Code
Fort Branch, IN 47648 9ZQ2 . -. -
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Country Country U a 1,
best of my knowledge and be ief, i r , c r c , and complete as
required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally i i e value of transferred
real pro erty, or omits or falsifies any information required to be provided, commits a Level 5 felony.
Sig re of Seller Signature of Seller
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P i t d Name o Seller I Date Signed (mm/ddlyyyy) Printed Name of Seller Date Signed (mrn/dd/yyyy)
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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 on conveyance document
Stephanie Diephuis Joseph E. Diephuis
Address (number and street) Address (number and street)
1 507 South Main Street 507 South Main Street
City, State, and ZIP Code City, State, and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country wt.. Country c
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 SQ 1. Will this property be the buyer's primary 0 3. Homestead
41,* residence?
O .4%(:50 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 5. Wind Power Device tom' ,, r '
❑ for this residence? if yes, provide address: ❑ 0 6. Hydroelectric Power Device-`' ' t.
Address (number and street 0 . 7. Geothermal Energy Heating or Cooling Device
q)1 YW.m
City, State and ZIP Code County
t,, te « - 13-G o u -COO . SIACI —o26 _
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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/ID/Other Number is necessary only if a Homestead Deduction is being filed.)
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