HomeMy WebLinkAboutHomestead_PurdueH. PREPARER
Preparer of the Sales Disclosure Form Title
Chris Henderson Closing Speciailist
Company Email Address Telephone Number
Security Title Services chenderson@stindy.com ( 317 ) 818-2999
Address (number and street, city, state, country, and ZIP Code)
9225 Priority Way West Drive, Suite 110, Indianapolis, IN 46240
I. SELLERS)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document Seller 2 — Name as appears on conveyance document
Robert A. Bise Terry Ann Bise
Address (number and street) Address (number and street)
C _ ,Cabe-
City, State, and ZIP Code City, State, and ZIP Code
Country eau""y
E Address Telephone NumbeT Email Address Telephone Number
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I X ) t2 ),
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 6-1.1-5.5. 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.
Sign of eller Signature of Seller
rw�
ri ed Name of Seller Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Robert A. Bise y r Terry Ann Bise nyl2ql k
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 appea ow4ebance- document
Hunter Purdue -�
Address (number and street) Address (number and street)JL
1 I * W 1-0 5-
City, State, and ZIP Code City, State, and ZIP Code ��® 0 9
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Country Country
Email Address Telephone Number Email Address 12c %f C- jephQne tuber
(ir'n Sen s�(i w�(.G��. (�2 )Y�3ISS� GIBSON C (.. ; )
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
O 1. Will this property be the buyer's primary '6 O 3. Homestead
residence? O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated O 5. Wind Power Device
for this residence? If provide , esaddress:
Y p O 6. Hydroelectric Power Device
Address (number and street O 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County �/ 1 j__) `hod _ jC,� �jC) (0 _ r�
Under penalties of perjury, I h reby 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 fi-1.1S.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
n num—_r-. I nn/nlF. iu...,,tie.:� .,a....— , nnhr if a Mnmaefead narlur_tinn is beinu filed.)
Signature of Buyer 1
Signature of Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Hunter Purdue
Last 5Dqgits of Buyer 1 SSN/Driver's License/ID/Other Number
I
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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