HomeMy WebLinkAboutHomestead_Rivera (2)�) H. PREPARCR 1
rer of the Sales Disclosure Form I Title
FYKYLE
WALTON
Company
Email Address
Telephone Number
kyle5953@gmail.com
( 812 ) 620. 6651
Address (number and street, city, state, country, and ZIP Code)
1112 PINE MEADOW DRIVE, SALEM, INDIANA 47167 it
f
I I SELLERS)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
j SABRE INVESTMENTS LLC
Address (number and street)
Address (number and street)
P.O. BOX 3074
City, State. and ZIP Code
City, State, and ZIP Code i
CARBONDALE, ILLINOIS 62902
I
Country
Country
US
Email Address
Telephone Number
Email Address
Telephone Number '
( 618 ) 457 . 4334
(
Under penalties of perjury, I hereby certify 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 I�
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
Signature of Seller
'
Signature of Seiler
/�
�f� �t✓ �'G',i frs'
i
Printed Nameeller
;F
Date Signed (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Kyle Walton, Authorized Agent_
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAK DEDUCTIONS — IDENTIFY ALL THAT APPLY
j Buyer I — Name as it appears on conveyance document
Buyer 2 — Name as it appears on conveyance document
OSCAR ALFREDO ALFARO RIVERA
VERONICA PAULINA CHICO CARRASCO
Address (number and street)
Address (number and street) i
j 70 DUPONT STREET
70 DUPONT STREET
City, State, and ZIP Code
City, State, and ZIP Code
NORTH PLAINFIELD, NJ 07060
NORTH PLAINFIELD, NJ 07060
i Country
Country l
US
US
Email Address
Telephone Number
I Email Address
Telephone Number
( Pursuantto 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 j
1. Will this property be the buyer's primary
O✓ 0 3. Homestead
residence?
O 2 4. Solar Energy Heating or Cooling System
0 0✓ 5. Wind Power Device
O D 2• Does the buyer have a homestead to be vacated
1 for this residence? If yes, provide address:
0 p 6. Hydroelectric Power Device
0 QQ 7. Geothermal Energy Heating or Cooling Device j
j Address (number and street)
i 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
j transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's
information,)SSN/Driver's License/ID/Other Number is necessary only if a Homestead Deduction is being riled) �I
Sign�tur o u. Si tur yer 2lSpouse
Date (MM/DDY)
/Jinfe Le Name of uyer Sign /Y
� �
e f Bu r ti
al 2/Spo a Sign Date (MM/DDNY)
/ a �
_ign
LasV5 Digits of Buyer SN/Driver License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Drivees License/ID/Other Number
Page 3
Title
Email Address
kyIe5953(a
Address (number and street, city, state, country, and ZIP Code)
1112 PINE MEADOW DRIVE, SALEM, INDIANA 47167
I. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
SABRE INVESTMENTS LLC
Address (number and street)
P. O. BOX 3074
City, State, and ZIP Code
CARBONDALE, ILLINOIS 62902
Country
US
Email add —
Telephone Number
ail.com I ( 812 ) 620. 6651
Seller 2 — Name as appears on conveyance document
Address (number and street)
City, State, and ZIP Code
Country
ess Telephone Number Email Address
( 618) 457 . 4334 Telephone Number
Under penalties of perjury, I hereby certify 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.
Signature of Seller Signature of Seller
Printed Name
,,�Meller �Datemm/dd/yyyy) Printed Name of Seller
Kyle Walton, Authorized Agent Date Signed (n-.�
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 — Name as it appears on conveyance document
OSCAR ALFREDO ALFARO RIVERA Buyer 2 —Name as it appears on conveyance document
VERONICA PAULINA CHICO CARRASCO
Address (number and street) Address (number and street)
70 DUPONT STREET 70 DUPONT STREET b~
City, State, and ZIP Code
NORTH PLAINFIELD, NJ 07060 City, State, and ZIP Code `f
Country
NORTH PLAINFIELD, NJ 0060
US Country r
US 41,
Email mail Add
Address Telephone Number Eress C r
�''elephone Num
Pursuant to IC 6.1.1-12-44, the Sales Disclosure Form may be used to
YES NO CONDITION
I] O I. Will this property be the buyer's primary
residence?
O 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
Address (number and street)
H. PREPARER
Preparer of the Sales Disclosure Form
KYLE WALTON
Company
pply for certain dedu�lp . Itify all of those that ply:
YES NO CONDITION NjY``vR
O O 3. Homestead `1 VOy
O
O ( 4. Solar Energy Heating or Cooling System
O O✓ S. Wind Power Device
O O✓ 6. Hydroelectric Power Device
O O✓ 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
-�a-0 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
informatlo SN/Driver's License/!D/Other Number is necessary only if a Homes
Si ad uction is being filed.)
Signatur 2/Spouse
e9 m of B r 1 Sign Date (MM/DD/YY) Pr' ted gal of Buy r 2/S ou
P Sign Date (MWDD/YY)
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Page 3
H. PREPARER
Preparer of the Sales Disclosure Form Title
KYLE WALTON
Company Email Address Telephone Number
(
kyle5953@gmail.com 812 ) 620. 6651
Address (number and street, city, state, country, and ZIP Code)
1112 PINE MEADOW DRIVE, SALEM, INDIANA 47167
I. SELLER(S)IGRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
SABRE INVESTMENTS LLC
Address (number and street)
Address (number and street)
P. O. BOX 3074
City, State, and ZIP Code
City, State, and ZIP Code
CARBONDALE, ILLINOIS 62902
Country
Country
US
Email Address
7Telephone Number
Email Address
Telephone Number
618 ) 457. 4334
( )
Under penalties of perjury, I hereby certify 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.
Signature of Seller Signature of Seller
Printed Name of Seller :[!!
Kyle Walton, Authorized Agent
igned (mm/dd/yyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS
— IDENTIFY ALL THAT APPLY
Buyer 1 — Name as it appears on conveyance document
BERTILIO DUBON
Buyer 2 — Name as it appears on conveyance document
ROSA E. RIVERA
Address (number and street)
Address (number and street)
6530 S. 750 W
6530 S. 750 W
City, State, and ZIP Code
City, State, and ZIP Code
HUNTINGBURG, IN 47542
HUNTINGBURG, IN 47542
Country
Country
US
us
Email Address
7Telephone Number
E ail Address
Telephone Number
12 ) 309. 8783
( )
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
O O 1. Will this property be the buyer's primary
O O 3. Homestead
residence?
O CO 4. Solar Energy Heating or Cooling System
O O 2. Does the buyer have a homestead to be vacated
O O✓ 5. Wind Power Device
for this residence? If yes, provide address:
O CO6. Hydroelectric Power Device
O 27. 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, SSN/Driver's License/1D/0ther Number is necessary only if a Homestead Deduction is being riled.)
Signat r 1 Sig ture of Buyer 2/Spc�us
Pnn a ega ame oZlm,.r Sign Date (MM/DD/YY)
BERTILIO DUBON • /5
Printed Legal Name of Buyer 2 pouse Sign Date (MM/DD/YY)
ROSA E.
RIVERA r. /. - Ac-
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Page 3