HomeMy WebLinkAboutHomestead_KorffIREP
Preparer of the Sales Disclosure Form
Title
Suzy Laros
F-scrow Officer
Com y
erldian Title Corporation
Email Address
Telephone Number
( 317)
ind meridiantitle.co
885-2602
Address (number and street, city, state, country, and ZIP Code)
1675 W Smith Valle Rd., Ste. E4, Greenwood, IN 46142
1:SEL�3ER(��1GRANZOR(5��:.. :_ . • �.: � :...:.:.. .:, •... , .. - .
Seller 1— Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Patrick Talley
Tracy Talley
,Address (number and street)
Adri-- r. —F—, n i 455 Taft Ave
455 Taft Ave
x
c' . .ava�c�r.a�.,.,.,.�,.,.. &j� yn, 1L 60 131smote
_aljd ZIP code r,len Ellyn, IL 60137
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entry �N: { �Q ,S1-4-t
E ail Address Telephone Number x
E a' Ad
Telephone Number x
,:
Underpenaltfes:of �L._ Y�?�fi/tifis Sales.Diisdcisure, to the bestof:my lmowiedge- belief- .hi true--. connect, and_aomplete;as
requin:d by tavr aril isprepared:In accordance with.IC f-1:1a.5.-A peisorfwho laiowin lyand lntentionally-falsHies:the veiue of transferred
9
rty;' omits or falsl[fes.an ;iriformatlon.re ulred to be provided; commits: a Level:5 felony:...:
real° .. y 9
nature Seller
Sjonfure of Seller
Printed Name of Seller
Date Signed (mm/dd/yyyy)
ri"Name hf S tl
Date Signed (mm/ddlyyyy)
Patrick Talley
2,S 2 �
y ey
Z; ? G
-J, ;BIJYER.(s), RANTEE(S) APPLICATION FOR PROPERTY"TAX DEDUCTIONS'-1DEN MY ALL THAT APPLY
Buyer 1— Name as it appears on conveyance document
Buyer 2 — Name as �t appears yn conveyance document
Megan H orTT
Brent M. Korff
Address (number and street)
Address (number and street)
8895 South 100 West
8895 South 100 West
City, State, and ZIP Code
City, State, and ZIP Code
Fort Branch, IN 47648
Fort Branch, IN 47648
Country
Country
USA
USA
Email Address
Telephone Number
Email Address
Telephone Number
f?irtsuaritto:tC 671:1= I:Z=4t; ttie Sates. Lttsdosure:Form maybe used to apply -for ceriam ded _ .ors. Identify all of:those ttfat'apPly:
YES NO CONDITION
YES NO DITION
O 1. Will this property be the buyer's primary
O 3. Homestead
residence?
O O 4. Solar Energy Heating or Cooling System
O O 5. Wind Power Device
O O 2. Does the buyer have a homestead to be vacate
for this residence? If yes, provide address:
O O 6. Hydroelectric Power Device
or Cooling Device
O O 7. Geothermal Energy,,
Address (number and street)
rrHeating
City, State, and ZIP Code county
Under.penWt'ies of.perluq, l:hereby: fhatthhi Sales Disclosure, to the best of my�laronriedge acid belie : istraie; correct, and complete
... .
as•requined by Iaw,.and:is pre lh accordance wrfh:IC:6-1.1-6.5: A person who Igropnrigly.and intention' fals'. the,value:of
tiansferied neaP,properly, or, or falsifies'any information.regmred'to be pnivided, eomrnits:a Level 54.oriy spouses
'
infoimation;BSWD[iger's cease►9D/OtlreNumbeiisnecessaryon/yifallomesfeadlfledue6oir_fsbeing,filedJ:
. .. . ,
Signature of Buyer 1
Signature of Buyer 2/Spouse '
Printed Leg ame of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/
JU
BpM M. Korff
Megan A. Korff
Last 5 Digits of Buyer 1 SSN/Drivees Ucense/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's U nsell / ?Vumber
Page 3 G/esOV�
'�11p/
K PREPARER
Preparer of the Sales Disclosure Form I Title fi
Suzanne Laros Closer
Company I E-mail Address
Telephone Number j
Meridian Title Corporation GreenwoodOffice ,MeridianTdle_com
(317)885-2602
Address (number and street city, state, country, and ZIP Code)
1675 W. Smith Valley Rd., Ste. E4, Greenwood, IN 46142
4
i
L SELLER(S)IGRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Sirva Relocation Credit, LLC
Address (number and street)
Address (number and street)
e City, State, and ZIP Code
City, State, and ZIP Code
Country
Count
United States
ited States
E-mail Address i Telephone Number i
E-mail Address
Telephone Number
Under penalties of perjury, I hereby certify this Sales isclosure, to the best of my knowledge and belief, is trite correct and complete as
required by law, and is prepared in accordance IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of transferred
real property, or omits or falsifies any info on required to be provided, commits a Level 5 felony.
Signature of Seller ( Signature of Seller
I !;
Printed Name of Seller
Date Signed (mm/dd/yyyy) i Printed Name of Seller
Date Signed (mm/dd/yy)y) -
E J. BUYER(S)iGRANTEE(S) -- APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY R
_
Buyer 1 — Name as it appears on conveyance document
i Buyer 2 — Name as it appears on conveyance document
Brent M_ Korff
I
Megan A_ Korff
Address (number and street)
''Z25 Bi ( viikiavia Roaj
Address (number and street) I
jQZZc5 00ig -0C' �
City, State, and ZIP Code
i City, State, and ZIP Code
y7�70
i Ev sv;ftQ IuJ , LJ-1-120
Country
Country
United States
United States
E-mail Address i Telephone Number
I E-mail Address
Telephone Number
(
`7boldS� (1GIr1411.c��-I^ I 911-1I1 23qY
t[L-toI-K(03
Pursuant to IC 64.1-12 44, the Sales Disclosure Form may be used to apply for certain deductions: Identify all'of those that apply:
YES NO CONDITION
i YES NO CONDITION
❑ 1. Will this property be the buyer's primary
[Z ❑ 3. Homestead
i residence?
❑ 4. Solar Energy Heating or Cooling System
❑ 2. Does the buyer have a homestead to be vacated
❑ 5. Wind Power Device
for this residence? If yes, provide address:
❑ 6. Hydroelectric Power Device tt
❑ 7. Geothermal Energy Heating or Cooling Device
3
Address (number and street
�1F,
`Z2
kl
, i. L it
ei &lei
s
City, State, and Z P Code 1 �1 / 1 County
/
(ViLlP 1 V1 iTl 0 'Va"l,A2bu �
f
Under penalties,of e . 1 p p gory, I hereby certify That this Sales Disclosure, to the best of my knowledge and belief, is Prue, correct and complete
as required by law, and is prepared in accordance with IC 6 '1 15.5_ A person'who knowingly and intentionally falsifies the value'of : , i
transferred real properly, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note- Both spouses .
information, SSWDnver's LicensellD/Other Number is necessary if a Homestead Deduction is being filed)
Sign?V�re of Buyer 1 j Signature of Buyer 2ISpouse
Printed Legal Name of Buyer 1
Sign Date (MM/DD/YY) Printed Le al Name of Buyer 2/Spouse
Sign Date (MM/DD/YY)
Brent M_ Korff
Megan A_ Korff
1
Last 5 Digits of Buyer SSN river's License/ID/Other Number Last 5 Digits of Buyer 2/Spous SS rivees license/ID/Other Number
ZL I G 2G5
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