HomeMy WebLinkAboutHomestead_Allen (2)H.PREPARER
Preparer of the Sales Disclosure Form —
-title T
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
The Martha E. Allen Revocable Living Trust, dated the 18th day of Januar
Address (number and street)
7133 W Short Lane
Address (number and street)
City, State, and ZiP Code
City, State, and ZIP Code
Owensville, IN 47665
_ __...
Country -- -- —
Country
us
Email Address
Tejk-phone Number
Email Address
Telephone Number
Under penalties of perjury, 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 o_ r falsifies any information required to be provided, commits a Level 5 felony.
Stu e of Seller
Signatu a of Sellan
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Printed Name Sell
Date Sjgge�(rpm/dd/yyyy)
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Pr' ed Name of eller
Date Sjg d m/dd/yyyy)
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Robert Troy Allen, Co -Trustee
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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 corlUXance document
Bobbie Jo Allen
u
Address street)
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Address (number and street)
(number and
6119 W 250 S
City, State, and ZIP Code
City, State, and ZIP Code
Owensville, IN 47665
—
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Country
Country - r ' J LI►[n
us
Email Address
Telephone Number
Email Address
Telepho a Number
uo
Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. lie nti a.
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YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
® O 3. Homestead
® O residence?
O ® 4. Solar Energy Heating or Cooling System
O (9 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
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for this residence? If yes, provide address:
p 9 g, Hydroelectric Power Device
O ® 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
r'�r_�d3-orR1
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
information, SSN/Driver's License/tDlOther Number is necessary only if a Homestead Deduction is being riled.)
Stur
iTCIU
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Signature of Buyer 2/Spouse
�B(u�yer
lac. 0 C rti
Printed Legal Naof Buyer 1 Sign Date ( /D
m
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Bobbie Jo Allen
Last 5 Di its of BuyerSN/Driver's LicensellD/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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