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HomeMy WebLinkAboutHomestead_EstuestaH. PREPARER Preparer of the Sales Disclosure Form Title Milton Norman Settlement Agent Company Email Address Telephone Number Hometown Title LLC orders@hometowntitles.com ( 812 ) 461-6399 Address (number and street, city, state, country, and ZIP Code) 25 NW Riverside Drive, 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 Mission Real Estate Group Inc Address (number and street) Address (number and street) tt 328 E Oak St )11�1 City, Slate, and ZIP Code City, State, and ZIP Code Princeton, IN 47670 El Country Country Us I �f Email Address Telephone Number Email Address �lephone Number Under penalties of perjury, I hereby certify this Sales Disclosure, tote best of my knowledge an 'v i e, correct, and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intenti�j4yy s the value of transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. 9C/ Signature of Seller_ f"�. F • Signature of Seller OR s Printe, a-Nwe of Seller . = Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mmldd/yyyy) James M. Chappell, President C/ - /i 7,--,; /' . 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 Robelie Re atacodo Estuesta Roberto F. Evangelista Address (number and street) Address (number and street) 316 West Emerson Street Apartment APT D 316 West Emerson Street Apartment APT D City, State, and ZIP Code City, State, and ZIP Code Princeton, IN 47670 Princeton, IN 47670 Country Country us Email Address Telephone Number Email Address Telephone Number robelleestuesta21@gmaiLcom ( • g" 3a5-25,g4 Obetevangelista2D@gmaiLcom B f2 j 3>Ttr 401 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 1. Will this property be the buyer's primary ® 0 3. Homestead ® 0 residence? 0 ® 4. Solar Energy Heating or Cooling System 0 ® 5. Wind Power Device 0 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device 0 ® 7. Geothermal Energy Heating or Cooling Device 26-12-07-201-000.201-028 Address (Lumber and street) City, State, and ZIP Code County 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 in rmation, SSN/Driver's LicensellD/Other Number is necessary only if a Homestead Deduction is being filed.) 'Buyer 1 Y 41vilYV Signature of Buyerg Spouse g Pr' v�l C . ~ . ' i ted Legal Name of Buyer 1 Sign Date (MM/DD/YY) Pri ted Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) Robelle Repatacodo Estuesta liiRoberto F. Evangelista Last 5 Digits of Buyer 1 SSN/Driver's License er Number Last 5 Digits of Buyer 2/Spouse SSN/Drive' License/ID/Other Number Page 3