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HomeMy WebLinkAboutHomestead_MayH: PREPARER Preparer of the Sales Disclosure Form Title Dana Martin AGENT Company Email Address Telephone Number ServiceLink Origination Title and Close DANA.MARTIN@SVCLNK.COIv ( > Address (number and street, city, state, country, and ZIP Code) 1355 Cherrington Parkway Moon Township, PA 15108 SELLER(S)IGRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as appears on conveyance document IT MICHAEL MAY AKA KEITH M. MAY SYLEST T. PACE FKA SYLEST T. MAY Address (number and street) Address (number and street) 3961 N KUNKEL LN. 316 N Gibson St. City, State, and ZIP Code City, State, and ZIP Code PATOKA, IN 47666 Princeton, IN 47670 Country Country ` Email Address •t��,a ( :�.co� Telephone Number ($(Z ) &tpq-71�14p Email Address SYle5t.pac-eC6M 1(2-70 Telephone Number )3OR558') nder penalties of perj ry,1 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 6-1.1ti5.5. A personwho knowingly and_ ritentionally falsifies the value of transferred real property, or omits orfaisifles anylnforniation required to be provided, commits a Level 5 felony. Signat of eller ature of Seller P ' ted Name of S er Date Signed (mmlddlyyyy) Print me of Sailer ate S'gne (mm/dd/yy ) KEITH MICHAEL MAY AKA KEITH SYLE T T. PACE FKA SYLEST T. 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 conygyance document KEITH MICHAEL MAY U Tr Address (number and street) Address (number and street) ED 3961 N KUNKEL LN. City, State, and ZIP Code City, State, and ZIP Code PATOKA, IN 47666 Country Country Email Address Telephone Number Email Address Telephone Number PiNn rt,,�"j. cr��--i (�12 > ed-c -7 1 2�LL � Pursuant t IC 64.1-1 , the Sales Disclosure Form may be used to apply for certain deductions. Identify a o . e that a ply' YES NO CONDITION YES NO CONDITION 1. Will this property be the buyer's primary © O 3. Homestead residence? O (D 4. Solar Energy Heating or Cooling System O O 5. Wind Power Device 2. Does the buyer have a homestead to be vacated O O for this residence? If yes, provide address: O p 6. Hydroelectric Power Device O p 7. Geothermal Energy Heating or Cooling Device Address (number and street) oc� City, State, and ZIP Code County Under penalties cif.06 jury,.thereby certify that. this Saliag Disclosure to the.bedt of my knowledge and belief, is true, correct; acid complete as required bylaw, and. is prepared in accordance with IC 64.165:5. 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, SSAVDriver's Lic nsallD/Other Number is necessary only if a Homestead Deductfoh is being riled.) Signature of B er/� Signature of Buyer 2/Spouse 5 Printed L al Name of Buyer Sign Dat (M /DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) KEITH MICHAEL MAY Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number ism Page 3