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HomeMy WebLinkAboutHomestead_ColemanH.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 {. SELLER(S)IGRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as appears onionke n doc e t Morgan J. Hinton Address (number and street) Address (number and street) -AL dr 8913 County Road 360 South City, State, and ZIP Code City, State, and ZIP Code 2026 Oakland City, IN 47660 Country Country ' us GIBS Email Address Telephone Number Email Address Ty Number �� ( 512- ) 5-92 -0 Y37 ( 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 or falsifies an formation required to be provided, commits a Level 5 felony. Signatu o Signature of Seller Printed Name of Sell Date Sigr?ed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy) Morgan J. Hinton t I BUYER(S)IGRANTEE(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 Jennifer Coleman Brvan Coleman Addres (number and street) Address (number and street) , o 5 Cityte, andyPCode �/ �% �L tcu �� City, State, an Co Country Country US us Email Address Telephone Number Email Address Telephone Number ( $ i Z. )Q.cp---s-128 I I (-I�la )&k-4%-2t C� rsuant 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: ES NO CONDITION rY YES NO CONDITION 1. Will this property be the buyer's primary ® O 3. Homestead ® O residence? O (N 4. Solar Energy Heating or Cooling System O ® 5. Wind Power Device 2. Does the buyer have a homestead to be vacated O for this residence? If yes, provide address: O ® 6. Hydroelectric Power Device O ® 7. Geothermal Energy Heating or Cooling Device )(_ t -B� - 1 oo _ o�� -Is ` (P — 00 Address (number 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 bylaw, 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 J SSA/Driver's LicensOD/Other Number is necessary only if a Homestead Deduction is being filed.) f Buyer 1 ture of Buyer 2/S usof �Ouluowlo', S.al Na a of Buyer 1 Sign Date (MM/DD/YY) Printed gal Name of Buyer 2/Spouse Sign Date (MMIDD/YY) leman Brya Coleman s of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number aj Page 3