HomeMy WebLinkAboutHomestead_Reneer (11) — - c-
H. PREPARER
- �
Preparer of the Sales Disclosure Form Title
Milton Norman _ _ Settlement Agent -- _
Company ~
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Dnve, Suite 310, Evansville, IN 47708
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveyance document
Jackie Bruce Purkiser, II4.
Address (number and street) Address (number and street)
701 S Gibson St. E-14
City, State, and ZIP Code City, State, and ZIP Code4..1
Princeton, IN 47670 .40'
Country Country /
US �11
Email Address
of my knowledge and beliefi;i��e ect, and complete as
required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally ldl value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. ..b0/TOE
Sig 'ate -r Signature of Seller A '
P : . Name of Seller Date Signed (mm/dd/yyyy) Printed Name of Seller 1 Date Signed (mmlddlyyyy)
..ckie Bruce Purkiser, II ..3'4-2.6
J. BUYERS)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 - Name as it appears on conveyance document 1 Buyer 2 - Name as it appears on conveyance document
Charles Zachary Reneer I, Katelyn McCoy
Address n b nd street) Address n m• and treet)
I.
, State, and ZIP Code C' State, and ZIP Code
r- A , � ilThc1 . _ nttC s1 T1(
Country Country
US US
Email Address Address
YES NO CONDITION YES NO CONDITION
® 1 . Will this property be the buyer's primary ® 0 3. Homestead
r
O ® 4. Solar Energy Heatirl or C6
residence? bling System
O O 2. Does the buyer have a homestead to be vacated O ® 5. Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
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Address (number and street) 0 ® 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County -A - 12--G 1 - 1-m 3 - 0 00 1 4\ =0
24 ,
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
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