HomeMy WebLinkAboutHomestead_Miley (2)H. PREPARER
Preparer of the Sales Disclosure Form
Title
Milton Norman
Settlement Agent
Company
Email Address
Telephone Number
Hometown Title LLC
orders@hometowntiUes.com
( 812 ) 461-6399
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
1. SELLER(S)MRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 —Name as appears on v ya ocu
Angela Vanpelt a/k/a Angela Liberty
Address (number and street)
Address (number and street)
1701 Boulevard Place
City, State, and ZIP Code
City, State, and ZIP Code 6
202
Princeton, IN 47670
Country
Country
8/84%1,
us
Errrail Address
Telephone Number
( )
Email Address 1N
umber
( IToR
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 6-1.1-6.5. A person who knowingly and intentionally falsifies the value of:transfarred
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
Date Signed (mm/ddlyyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Angela Vanpelt a/k/a Angela Liberty
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 conveyance document
Destanee MileV
Nicole Price
Address number d st
4d" s (nu ber nd s ,
�
ity, State, and ZIP Code ^ �1�
State, and ZIP/Code ,! __ r
Coun♦u�J�/�',
Country r. _
us lo�
US
Email Address
T iephone Number
12 )��Jr�7C�9(p
Email Address
'•.1-�'
Tele hone Number
!K"i YltJl
Pursuant to IC 64.1-12-44, the Sales Disclosure Form may be used .apply r certain deductions. Identify all of those that appl :
YES_ NO CONDITION
YES MO CONDITION
1.. Will this property be the buyer's primary
(R O 3. Homestead
® O residence?
p (9 4. Solar Energy Heating or Cooling System
O ® 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
O for this residence? if yes, provide address:
0 6. Hydroelectric Power Device
D 12 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
1�- `�- 3 � - �`�\ , A� �a
City, State, and ZIP Code County
Under penalties of penury, I. her+eby.certify that this Sales Disclosure,.to the best of my knowledge and belief, Is true,pormct, and complete
as required by law, and Is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies4he 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, SSNIMNer's LicensedDlOfher Number is necessary. only Wa Homestead Deduction Is being flied)
tore of I
Signature of Buyer 2/Spoule "
/Buyer
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name bf Buyer 2/SpoUse Sign Date)MD
DIY`()
Destanee Miley C."
Nicole Price
b
Last 5 Digits of Buyer I SSITDriver's License/1D10ther Number
Last 5 Digits of Buyer 2/Spouse SSN/Driveea License/1 Other Number
Page 3
H.PREPARER
Preparer of the Sales Disclosure Form True
Milton Norman Settlement Aoent
Company Email Address
Telephone Number j
Hometown Tide LC orders@hc)metowntitles.com
( 812 ) 461-6399 i
Address (number and street, city, state, country, and ZIP Code)
25 NW Riverside Drive, Suite 310, Evansville, IN 47708
P
I. SELLER(S)IGRANTOR(S)
Seller 1 — Name as it appears on conveyance document
Seller 2 —Name as appears on conveyance document
Angela Vanpelt alk(a Angela Liberty
Address (number and street)
Address (number and street)
1701 Boulevard Place
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 4767D
Country
Country
uS
E 11 ddress t
T ephone Number
Email Address
Telephone Number
( )
Unde penal" s p.5&y, h by ce fy this Sales isclosu—M, to the best of my knowledge and belief, is true, correct, and complete as
required by law, nd is prepared In accordance with IC 6-1.1-5.6. 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 5 felony.
tireSe I
Signature of Seller
a
M
d Name or 5 er
ie S e (mnUdd! }
Printed Name of Seller
Date Signed (mmlddlyyyy)
Angela Vanpelt alk/a Angela Liberty
> U
J. BUYER(S)IGRANTEE(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 uoriveyance document
Destanee Miley
Nicole Price
Address (number and street)
Address (numberand street)
City, State, and ZIP Code
City, State, and ZIP Code
Country
Country
us
us
Email Address
Telephone Number
Email Address
Telephone Number
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
® ❑ 1, Will this property be the buyer's primary
W D 3. Homestead
residence?
❑ ® 4. Solar Energy Heating or Cooling System
0 (25. Wind Power Device
2, Does the buyer have a homestead to be vacated
❑ ❑
for this residence? If yes, provide address:
❑ ® 6. Hydroelectric Power Device
❑ ® 7. Geothermal Energy Heating or Cooling Device
,I
Address (number and street)
City, State, and ZIP Code County
Under penalties of perjury,) 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. 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
lnformatron, SSN/Ortver's Llcerr MD/Other Number is necessary only ff a Homestead Deduction is being filed,)
Signature of Buyer 1
Signature of Buyer 2/Spouse i
Printed Legal Name of Buyer 1 Sign Date (MMlD01YY)
Printed Legal Name of Buyer 21Spouse Sign Date (MM(DDIYY)
Destanee Miley
Nicole Price
Last 5 Digits of Buyer 1 SSNlDrlver's LicensellDIOther Number
Last 5 Digits of Buyer 2lSpouse SSNIDriver's License/ID/Other Number
Page 3