HomeMy WebLinkAboutHomestead_AyersH.PREPARER
Preparer of the Sales Disclosure Form
Tide
Milton Norman
Settlement Agent
Company
Email Address
Telephone Number
Hometown Title LLC
orders hometowndtles.com
( 812 ) 461-6399
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
1. SELLER(S)IGRANTOR(S)
Seiler 1 - Name as it appears on conveyance document
Seller 2 - Name as appears on conveyance document
Rebecca K. Weber
Address (number and street)
Address (number and street)
724 W Aspen
City, State, and ZIP Code
City, State, and ZIP Code
Haubstadt, IN 47639
Country
Country
us
Email Address 0S 11"%C� I - coml
Telephone Number
Email Address
Telephone Number
C%Q, (0104.5y4y
( )
under pan alttes.of perjury, l hereby certify this Sates Disclosure, to the best of my knowledge and belief, is true, correct; and complete as
.required by law, and Is prepared to accordance with.IC 6-1.1.5.5. A person who knowingly and intentionally falsifies the value of transferred
real property, or omits ar falstfles any information required to be provided, commits a Level 5 felony.
Signature ofSet ler
Signature of Seller
Printed Name of. Seller
Date Si needd (( m/dddlyyyy}
Printed Name of Seller
Date Signed (mm/ddiyyyy)
Rebecca K. Weber
r dC%
J. BUYER(S)IGRANTEE(S) —:APPLICATION FOR. PROPERTY TAX DEDUCTIONS - IDENTI AT PPLY
Buyer 1 - Name as it appears on conveyance document
Buyer 2 - Name as it appears on conv doc
nM.Avers
Address .(number and street)
Address (number and street) A N
6/Ay
1207 Bowden Drive
Z
City, State, and ZIP Code
City, State, and ZIP Cod% 6
Evansville, IN 47725
Country
Country ult3
SON
us
GO(7'
Email Address
Telephone Number
Email Address
qf}o Number
bunnyrab66@yahoo.com
( 812 ) 677 0694
( i
Pursuant#o IC 6-1.1-12-44, the.Sales Disclosure Form may be used to apply for certain deductions. Identify all of those thafaipply:
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
❑ 3. Homestead
® ❑ residence?
❑ ® 4. Solar Energy Heating or Cooling System
❑ l� 5. Wind Power Device
❑ 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
p ® 6. Hydroelectric Power Device
❑ ® 7. Geothermal Energy Heating or Cooling Device
,� Lo _ � S _ 3(9 - dam- 000 . V1 I -
Address (number and street)
City, State, and ZIP Code County
Under penattles of perjury,.► hemby.certtfy that this Sales Disclosure, to the best of my knowledge and belief, Is true, correct, and .complete
as requ red.hylaw,.and is prepared In accordance with ICB-1A45. A person who knowingly and intentionally faisMes:the value of
transferred real property,.or omits or falsifies any information required to.be provided, commits a Level 5 felony. (Mote: Both spouse's
itfforrnation, SSWEiriver's Lfcense/ID10ther Mltrr6er is necessary ordy if a. Homestead Deduction is being Hied)
Signature of B
"�Q
Signature of Buyer 2/Spouse
NIQ q\t-
Printed Legal Na o Buyer 1 Ign Dat (M3 Y)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Jan M. Ayers
Last 5 Digits of Buyer 1 $N/Drive s License/@/Other umbe
Last 5 Digits of Buyer 2/Spouse SSN/Driver's LicensellD/Other Number
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