HomeMy WebLinkAboutHomestead_Coleman (2)H. PREPARER
Preparer of the Sales Disclosure Form
Title
......................
Company Email Address Telephone Number
( 812 ) 461-6399
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 I Seller 2 — Name as appears on conveyance document
naa..a... t - Re ee--6 Misti Marsh
Address (number and street) (number and street)
106 7th St St
EAddress
City, State, and ZIP Code te, and ZIP Code
Princeton, IN 47670 on, IN 47670
Country Country
us us
Email Address
lA "}.
Telephone Number Email Address
.rip. �' -'` .I.',;y>-',s7 '
L �- i�cit: �+v.'t�j,i�r:'
Telephone Number
'�• /1..� f `e - c i.=�,
r+ r
,i,;
.:�
Under penalties of perjury, I e-reby certify this Sales Disclosure, to the best of my knowledge and belief, Is true, correct, and complete as
falsifies the value of transferred
required by law, and is prepared in accordance with IC 6-1.1.5.6. A person who knowingly and intentionall
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
Sig re of S Iler `! / i, Signatu�a gB5�11
rin ed Narig of Steller Date Signed (mmldd/yyyy) Printed Name of Seller Dte Signed (mm/dd/ yyy)
Christopher M. Marsh 1 fr/ .'i" i'r /�i / Mistl Marsh
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 cone n ocument
Rick Coleman
Address (number and street)
Address (number and street)
106 S 1st St, Lot 3
City, State, and ZIP Code
City, State, and ZIP Code 4111,
Francisco, IN 47649
Country
Country 16
G'�eS
us
Email Address
Telephone Number
Email Address VCCU
ephone Nu r
reklaw1995@yahoo.com
( 812 ) 640-2395
Pursuant to IC 6-1.1-1244, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of 4: 6 1: apply:
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
® ❑ 3. Homestead
09
❑ residence?
❑ ® 4. Solar Energy Heating or Cooling System
❑ (@ 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
0 ® 7. Geothermal Energy Heating or Cooling Device
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 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 any information required to be provided, commits a Level 5 felony. (Note. Both spouse's
information, :SSWDrlver's L[cense11010ther Number is necessary only if a Homestead Deduction is being filed.)
Signature of er 1
Signature of Buyer 2/Spouse
Prime LegaI-Name of Ouyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 21Spouse Sign Date (MM/DD/YY)
Rick Coleman
Last 5 Digits ofj,,3uyer 1 SSN/Drnrer's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Page 3