HomeMy WebLinkAboutHomestead_ConnorH.PREPARER
Preparer of the Sales Disclosure Form
Title
Milton Norman
Settlement Agent
Company
Email Address
Telephone Number
Hometown Tille, LLC
orders hometowntiiles.com
( 812 ) 461-6399
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
I. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appearr ^rt conveyance document Seller 2 — Name as appears on conveyance document
Philip W. Miller as Trustees of the Paul E. Miller eS �u
_
Address (number and street) Address (number and street)
412 Roosevelt Dr
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Country
Country
us
Email Addreq
Telephone Number
Email Address
Telephone Number
WM:tr G.ct)AA 1(617,)0
614
( )
rider penalties of. perjury, F hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct; and complete as
required by IAW, and is prepared in accordance widr.lC A person who knowingly and intentionally falsifies the value of transferred
real pr pa,K,e6r omits or falsifts any informs quired to be provided; commits a Level 5 felony.
Signal oiler
Signature of Seller
[Ate NOOK Seller'*
Datcl ( mid }
Printed Name of Seller
Signed (mm/dd/yyyy)
Philip W. Miller, Co -Trustee
'{
7Date
J. BUYER(SYGRANTEE(S) — APPLICATION FOk PROPERTY TAX DEDUCTIONS:— IDENTIFY ALL THAT APPLY
Buyer 1— Name as it appears on conveyance document
Buyer 2 — Name as It appears on conveyance document
Travis W. Connor
Address (number and street)
Address (number and street)
1917 S Main St Rd
City, State, and ZIP Code
City, State, and ZIP Code
Vincennes, IN 47591
Country
Country
us
Email Address
Telephone Number
Email Address
Telephone Number
coachconnor2016@gmail.com
( 81.X ) 890-3822
1
( )
Pursuant to IC .6-1.1-12-44, the Sates Disclosure Form maybe used to apply for certaln deductions. Identify all of those that apply:
YES NO CONDITION
YES NO CONDITION
0 1. Will this property be the buyers primary
® 0 3. Homestead
residence?
0 ® 4. Solar Energy Heating or Cooling System
0 ® 5. Wind Power Device
0 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
0 ® 6. Hydroelectric Power Device
0 5 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
City, State, and ZIP Code County
Under penalties of perjury, I hemby,certify that this. Sales Disclosure, to the best of my knowledge and bellef, is true, correct, and complete
as required bylaw, 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, SSWDrivees Ucensa lLiOther Number is necessary only If a Homestead Deduction M being tiled)
Signature of Buyer 1
Signature of Buyer 2/Spouse
)e/ a
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Travis W. Connor
Last 5 Digits of Buyer 1 SSN/Drivees License/0/0ther Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
1 ITC)
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