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HomeMy WebLinkAboutHomestead_VaughnH. PREPARER Preparer of the Sales Disclosure Form Title Company Email Address Telephone Number ( 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 appears on conveyance document Seller 2 — Name as appears on coWzUance document J&B Loveless Co., LLC Address (number and street) Address (number and street) 1330 S Co Rd 75 E City, State, and ZIP Code City, State, and ZIP Code Winslow, IN 47598 AUG 25 Country Country us Email Address Telephone Number Email Address G'B Te phone Number 10uf-t' SON ) Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, c #%I 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 IA AJDO�- �y Signature of Seller Rfinted Name of Seller Date Signed (mm/dd/Myj Printed Name of Seller Date Signed (mm/dd/yyyy) Justin R. Loveless, Member .sue EA 'y J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY Buyer 1 — Name as it appears on conveyance document- I Buyer 2 — Name as it appears on conveyance document Address (number and street) Address (number and street) 39 N 275 W Rd 39 N 275 W Rd City, State, and ZIP Code City, State, and ZIP Code Princeton, IN 47670 Princeton, IN 47670 Country Country US us Email ,Address Telephone Number Email Address Telephone Number c)LN rr a_1 a_49-" thn Frirrn mail hp naed to nnniv for rertain deductions_ Identify all of those that aDDly: YES NO CONDITION YES NO CONDITION ® 0 1. Will this property be the buyer's primary ® 0 3. Homestead 7 residence? 0 (9 4. Solar Energy Heating or Cooling System 0 ® 5• Wind Power Device 2. Does the buyer have a homestead to be vacated 0 -A for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device 0 ® 7. Geothermal Energy Heating or Cooling Device Address (number and street) _) I _ lc�-�Y - v-7'15- ©a] 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, 5SN/Driver's LicensOD/Other Number is necessary only if a Homestead Deduction Is being filed.) Signature of Buyer 1 Signature of Buyer 2/Spouse F/ Printed Legal Name of Buyer 1 Sign Date (MM/DDNY) Pj led Leg. Name of Buyer 2/Spouse Sign Date (MM/DD/YY) Zachary Vaughn Morgan Vaughn Last 5 Digits of Buyer 1 SSN/Driver s License/lD/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number 3b-32& 1 5WL Page 3