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HomeMy WebLinkAboutHomestead_HouserK PREPARER Preparerof the Sales Disclosure Form Title Ami a Gass Settlement A ent Company Email Address Telephone Number Hometown Title LC orders@h metowntitles.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)IGRANTOR(S) Seller 1 — Name as it appears on conveyance document 5eller 2 — Name as ap n eya ent Jennifer L. Lantrip Address (number and street) Address (number and street) 227 E Monroe St City, State, and ZIP Code City, State, and ZIP Code �UZ� Princeton, IN 47670 Country Country us Email Address Telephone Number Email Address COON I phone Number nder penalties of peduiy,.I hereby certify this Sales Disclosure,.to'the best of my knowledge and belief, Is true, correct, and completeas required by law, and is prepared in accordanceWith IC 8.1.1-5.i3. A person who knowingly and Intentionally falsifies the value of transferred, real property, or omits orfalsifies any infonnation.required to: be provided; commits a Level s felony. 5i a re of Seller Signature of Seller Prin d Na o r D m ) Printed Name of Seller Dated e�d ( , d yyyy) Jennifer L. Lantrip )�J J. BUYER(S)IGRAN�TEE(S) -- APPLICATIO FO PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT PPL Buyer 1 — Name as it appears on conveyance document Buyer 2 — Name as it appears on conveyance document Travis Houser Livia Houser Address (number 5d s ) `% Address (number a et) c <j' k-oe— City, State, a ZIP Code t ' City, state IP Code Country Country us us Email Address Telephone Number Email Address Telephone Number 4�4 r-TV,:5(�-Aalq - M74( j� Pursuant to IC 64.1=t244,.the: les Disclosure Form may be used to apply for certain dedu ions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION ® 0 1. Will this property be the buyer's primary ® D 3. Homestead residence? © ® 4. Solar Energy Heating or Cooling System ®-� Power Device O 2. Does the buyer have a homestead to be vacated r this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device 0 ® 7. Geothermal Energy Heating or Cooling Device Address (number and street) �,� _ ��03, oo� • 1 �� — oa City, State, and ZIP Cade County Under penalties of perjury, t herebycertify 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 j 4.6. 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 S felony. (Note: Both spouse's Intb madoh, SSN/Driver'sr LicensellD/ather.Number is necessary only ff a Homestead Deduction is being Hkd ) Signature otj8pyer 1 Signs re of B r 2/Spouse Printed Le al Name of Buyer 1 Si D /f (1')()Printed Legal Na of Buyer 21pouse Sign Date (MMIDDIYY) Travis Houser < Livia Houser — If e / Last 5 Digits of Buyer 1 SSN/Driver's License!@!Other N mb Last 5 Digits of Buyer 2/8pouse N/Driver's UcenseAD/Other Number s � Page 3