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HomeMy WebLinkAboutHomestead_Hall H. PREPARER r __ Preparer of the Sales Disclosure or —"'� "� - �`"� -- - y--= ffi " _ Title �' - - —r /.��.�_•_ i -. '1 = ctAiroER Company p y Email Address Telephone Number ( ) --_- Address (number and street, city, state, country, and ZIP Code) — -� - __ --- — -- - I. SELLERS)/GRANTOR(S) -� � --�`---"'------ - Seller 1 -Name as it appears on onveyance document - _ Seller 2 - Name as appearsv —"�- 7A(susi_.4Eiic _ on conveyance document Address (number and street) - � Address (number and street) .Oa 5131 MILL. S.4- City, fate, and ZIP Code City, State, and ZIP Co e _ - -P44: k 4.-_____ OZ.. h 4 Country _ . IP_ 1 Country "nip --- i best of my knowled• - any, belief,li r -ect ,nd complete as 1 ,) required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly a '. ' ; . : , ait I ! •, . real property, or omits or falsifies any information required to be provided, commits a Level r+ '1; lue of transferred Signature of Seller _ _;.1e,�.CQl�7NTY AUDI Signature of Seller 1 doL,------- rinted ame of Seller Date Signed m/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy) J. BUYERS)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTI - • � -AT • • • LY Buyer Name as it a n ----- �_ - _ _ _ _ _ }� ppe rs conveyance document Mar1-16k1( Buyer 2 - Name as it appears on . ' re . c, docu - �- Addrls$ number and street) Address (number and street) - - 144J?{v� Dr _ APR 0 8 Cit State, and ZIP C e ` City, State, and ZIP Code T liatko, _ , 16 � 76 T Country Country GIBSO Nc� Ern it A++ dressc� r BNTl'e i A ress �yf�0 if •to�''t Telephone Number Email Address ll ( 1 hl ) 3 gs GIy Teleph�tl� Pmber Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for erta-in deductions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION rO1. Will this property be the buyer's primary O 3. Homestead _ residence? 0 0 4. Solar Energy Heating or Cooling Syatern -::, .: 2. Does the buyer have a homestead to be vacated '' 'T O O 0 0 5. Wind Power Device � _;{-' for this residence? If yes, provide address: -� - _ CIO 6. Hydroelectric Poiver Device Addre,, u rrbe a d treetoc�C Trie ii--ii 0 0 7. Geothermal Ene-gy Heating or Cooling Device Ci State, and ZIP Code County (476 X a lr--616/ . . 6---- lDI O �DD -- o U � 0 v� Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and betiief, 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 © Page 3