HomeMy WebLinkAboutHomestead_Richardson (2)H.PREPARER
Preparer of the Sales Disclosure Form
Title
Milton Norman
Settlement A ent
Company
Email Address
Telephone Number
Hometown Title, LILC
orders@h metowntibes.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
Seiler 2 - Name as appears on conveyance document
The Unsupervised Estate of Clara J. Lemmons a/k/a Jean Lemmons, filet
Address (number and street)
Address (numberand street)
1208 S Carol Ave
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Country
Country
us
Entail. Address
Telephone Number
Email Address
Telephone Number
Under penalbesvf perjury, f hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete. as
.required bylaw, and.is.prep4md In accordance with IC 6A.1-6.5. A person who knowingly and Intentionally falsifies the value oftransferred.
r8at.praperty; or omits or.falsfts any information required to be provided, commits a Level 5 felony.
Signature3 of Seller
Signature of Seller
rated Name of Seiler
Date.-P n1ed ((r�rr�/,ddlyyyy)
Printed Name of Seller
Data Signed (mm/dd/yyyy)
Donnie E. Hulfachor, Personal Represer
ry. ,'
J: BUY-ER(4)IGRANTEE(8):.�:APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL THAT APPLY
Buyer 1 - Name as it appears on.c:anveyance document
Buyer 2 - Name as it appears o ce document
a sit N. Richardson
Address (number and street)
Address (number and street)
563 S Spring St
City, State, and ZIP Code
City, State, and ZIP Code p'
A06 Z
Princeton, IN 47670
Country
Country
US
Email Address
Telephone Number
Email Address
GIBSON COUNT`��
�T?qep ne Number
( 618 ) 262-1774
Pursuant to IC:.6-1.1-12-44, the.Sates Disclosure Form may be used to applyfor certain deductions. Identifyall of those thafiapply::
YES NO CONDITION
YES NO CONDITION
® ® 1. Will.this property be the buyer's primary
i2 03. Homestead
residence?
p M 4. Solar Energy Heating or Cooling System
0 ® 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
O fit'
for this residence? if yes, provide address:
p 55 S, Hydroelectric Power Device
Q 12 7. Geothermal Energy Heating or Cooling Device
Address(number street)
- `C) _ oo 1 60((q - 0'�
City, State, and ZIP Code County
Under po altles of perjury, I hemby certify that this Sales Disctosure,.to the best of my knowledge and belief, Is true, correct, and complete
as required byiaw,.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. Sotb spouse s
4610mation, SSN/OrIver's Lfcens_,61IDIOrher Nutnbgr. l_s Necessary only ff a Homestead Doducdon is being fund )
Signature of Buyer 1
Signature of Buyer 2/Spouse
f
Printed Legal Name of Buyer 1 Sign Dalp (MMID MY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Chassi N. Richardson
Lasts Digits of Buyer 1 SSNIDriver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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