HomeMy WebLinkAboutHomestead_JenkinsH.PREPARER
Preparer of a Sales Disclosure' Form
Title
Settlement Agent
Company
Email Address
Telephone Number
Hometown dle LLC
orders@h metowntitles.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
Sue Ann Boyd
Sandra Kay Griffin
Address (number and street)
Address (number and street)
514N1stSt
514N1st St
City, State, and ZIP Code
City, State, and ZIP Code
Owensville, IN 47665
Owensville, IN 47665
Country
Country A/Av
6d,H
US
us
Email Address
Telephone Number
Email Address
i ��ro)e Number
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowled �� i ue, c rect, and complete as
A knowingly and into I�t the value of transferred
required by law, and Is prepared In accordance with IC 6-1.1-6.5. person who
real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony. i},
Signature of Seller
Aux 'w(
Signature of Seller /TCR
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Sue Ann Boyd I
- -t 9
Sandra Kay Griffin
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
Joyce F. Jenkins
Lisa Fa a Godwin
Address (number and street)
Address (number and street)
514N1st St
514NIstSt
City, State, and ZIP Code
City, State, and ZIP Code
Owensville, IN 47665
Owensville, IN 47665
Country
Country
US
us
Email Address
Wephone.NumbRr
Email Address
Telephone Number
�/-2—
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
(20 3. Homestead
® residence?
p ® 4. Solar Energy Heating or Cooling System
O (9 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
p CO 6. Hydroelectric Power Device
0 ® 7. Geothermal Energy Heating or Coaling Device
Address (number and street)
10 - ``I - N - ze 31-1 - C3� a c) ' C)�O
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 6-1.1.6.5. A person who knowingt and Intentionally falsifies the value of
transferred real property, or omits or falsifi ny information required to be pr idei c m a Level 5 felony. (Note: Both spouse's
/n atlon, S N/Drlver s Licenselli ber is necessary only !f a fioroeoteadD uc n is being filed.)
Sig ture of B er 1
Sin c of Buy 2/ pouse
n Wegal Nam o Buyer 1 Sign Date (MM(DD/YY)--Printed
Legal Namd of Buyer 2/Spouse Sign Date MM/DD/YY)
Joyce F. Jenkins
Lisa Faye Godwin
Last 5 Digits Byer 1 S NI/Driver's, License/ID/Other Number
Last 5 er 2/Spouse S /Drivers License/ID/Other Number
tocl 1-7
Page 3
Sailer —Nam as Rappears an conveyame domffmm
'saw
Sue Ann Boyd
Sandra Kay Griffin
Address (number and stowt)
Addnm (nurM*r*ftd`34"
N 15[ 6t
4-777
_114
City, State, RM ZIP Code
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M S,
Owensville, N 47665
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couritry
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us
us
Ernall Address Nuntor
Email Address
Sue Ann Boyd Sandra Kay Griffin
,44Z 7 4 e-(4
" AF!!!MEM .
J. BUYER(S)IGR�N
Buyer I — Yarn as it appears an convwonmdaaumrd� Buyer 2:— carm3yermdoemnea
Jovoe F. Jenkins Lisa Fa Godwin
Address (romber ad Ww) A*hm PA"ber 6e' ��ts!eat}:
514 N Ist S! 514 N 1st St
dity,Slate. and ZIP Code City. AN*, end 401 Coda
OwersMl!e. N, 47665 Owansviffle, IN 476.85
Country cdk�w
us us
PuraLm to M 6-11+11-11244
Yes No CGNDITMN
1. Will this property tft th o buyer's p
residenGe? ,riftiry
0 0 2. Does ft buyer have a homestea4 to be -vacated
for this residor;,�*T It yes, pmyke.addmm�
Address (nural)er and sitmet)
City, Stab, and ZIP Grade County
t'"Orms"awes of poor ayJA
Umt .41901,60"
Signature af Buyer I
Joyce F. Jenkins
Lost 5 Dim6 or BuVer I SSNIC
M Q 3- Hmra*W
0 :0 4. *tftr EhOW H686% 9r COOft;SYSWM
0 CM 5, VAnd Power Devte
HydMdoWw POW '0014100
T. G601:110MMIA OMWHOWAIG W Owlin 0-1.1000pe
Lisa Faye Godwin
ast 5 134%,Of 814
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