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HomeMy WebLinkAboutHomestead_MelvinH: PREPARER Preparer of the Sales Disclosure Fonn Title Katie Folly Escrow Officer Company Email Address Telephone Number Foreman Watson Land Title kfelly@fw-it.com (812 ) 909-4543 Address (number and street, city, stpte, country, and ZIP Cade) 7412 Eagle Crest Blvd Evansville, IN 47715 -C SELLER(S)IGRANTOR(S) Seller 1 — Name as it appears on conveyance docurnenl Seller 2 — Name as appears on conveyance document Ronald L. Hartley Address (number and street) Address (number and street) City, Slate, and ZIP Code ty ` L4 1 ric City, State, and ZIP Code Country Country us us Email Address Telep�hone umber Email Address Telephone Number (S 15 '7o,ag1(p ( } Under penalties a penury, i hereby certify this Sales Dlaclosure, to the best of my knowledge and bellef,.Is, true, correct, and complete as: required by law, and is prepared In accordance with tC 6-1.1-f+.b, A person who knowingly and Intentionally falsifies the value of transferred real property, or omits or ft [Mfies any Information required to be p►ovtded, commits a level 6 felony. ature of Seller Signature of Seller 1 Xed Name of Seller D to Sig (mm1d ) Printed Name of Seller Dale Signed (mrnlddlyyyy) Ronald L. Hartley 16/22/26 771 J. BUYER(9)MRANTEE(s) - APPLICATION FOR PR4PIERTY TAx DFDucTiONS - 116 NIT Y LL T P Y - Buyer'I — Name as it appears on conveyance document Buyer 2 — Name as it appears on conveyance Drake Melvin Address (nuipber an to ) Address (number and street) ' (� 2026 City, Stat , and ZI Code City, State, and ZIP .^ Country Country GIBSOfV ) COIJl�►Ty US US AUDITC? Email Address Telephone Number Email Address Telephono Number drakeiillvn@icloud.com (812 ) 661-763$ 1 ( ) Pursuant to IC 6.1.1.-12-44, the Sates 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 ® 1:1re 0 ❑ 3. Homestead tdence? Q El 4. Solar Energy Heating or Cooling System ❑ ❑1 S. Wind Power Device 2. Does the buyer have a homestead to be vacated 11 for this residence? If yes, provide address: © 0 6. Hydroelectric Power Device ❑r 7. Geothermal Energy Heating or Cooling Device (_ C)C' r r. 0 000 Address (number and street) City, State, and ZIP Code County Under peneltfas of perjury, I hereby. certify that this Sales Disclosure, to the best of my kn4wtedge and belief, Is true, correct,and complete as required by law, and. Is prepared in accordance with IC 6-1.1 6.b. A person who knowingly and Intentionally falsifies the value of transferred real property,or amlts or falsifies any Information required to be provided, commits a Level 5 felony. (Note: Both spouse's Injbrmatfok SSRMriveYs LfcenseADfOtharNumber is necessary only If Honiesteud Deduction is being filed./ S natur 0 it 1;iV Wz2— 4A-4� Signature of Buyer?/Spouse PoRted Legal Name of Buyer 1 Sign Date (MIAIDD/YY) Printed Legal Name of Buyer 21Spause Sign Date (MMMD/YY) rake Melvin 6l2?J26 Last 5 Digits of Buyer 1 SSN!Driver's LicensellDlOther Number Last 5 Digits of Buyer21Spouse SSN/Driver's LicenseAD/Olhor Number Last 5 of SSN: AP514 I Last 5 of SSN: Page 3