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HomeMy WebLinkAboutHomestead_HardinH.PREPARER Preparer of the Sales Disclosure Form Title Milton Norman Settlement Agent Company Email Address Telephone Number Hometown Title, LLC 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 Seller 2 -- Name as appears ve ance document Raquel Johnson Address (number and street) Address (number and stree 405 E Warrick St Vj) City, State, and ZIP Code City, State, and ZIP Code SEp Owensville, IN 47665 Country Country us Email Address Telephone Number ((91� )54a Email Address Telephone Number GISSON tV ) oag2 CO tV Under penalties of perlury,:F hereby certify this Sales Disclosure, to the best of my knowledge and belief, is tnid:166Kft and complete as raquired:by lave, and is:prepared in accordance with.11C .6-1.1.5.5. A person who knowingly and intentionall}r falsifies.the value of. transferred real property, or omits orfalsifies any information required to be provided, commits a Level 5 felony. Sign ture of Seller Signature of Seller Printed Na of Seller Date i9 d (mmlddiyyyy} Printed Name of Seller Data Signed (mm/ddtyyyy} Raquel Johnson I BUYER(S,)IGRANTEE(S):":APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY Buyer 1 — Name as it appears an conveyance document Buyer 2 — Name as it appears on conveyance document Caleb Hardin Address (number and street) \ Address (number and street) City, State, and ZIP Code City, State, and ZIP Code ` rr Country Country us Email Address Telephone Number (��tv} Q23— U13q Email Address Telephone Number c ) Pursuarit`to. IC .6-1.1.12-44, the,Sales Dlsclosure Form may 136 used to apply for .i stain deductions. Identify all, of those that apply: YES NO CONDITION YES NO CONDITION ® O 1. Will this property be the buyer's primary ® 0 3. Homestead residence? © (9 4. Solar Energy Heating or Cooling System 0 ® 5. Wind Rower Device 0 0 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: p ® 6. Hydroelectric Power Device Q ® 7. Geothermal Energy Heating or Cooling Device Address (number and street) City, State, and ZIP Code County Under penalties of padury,.l hereby certify that this Sales Disclosure, to the best of my knowledge and belief,, Is true,. Correct, and. complete as required bylaw, and is prepared in accordancomith IC 6-1.14.6. A person who knowingly. and Intentionally falsifies the value of transferred real property,..oromits 'or falsifies any ihformatlon required'to.be provided,. commits a Level felony. (Note: Both spouse's fbfoimafloh,. SSWDriv+er's LicensellblOther Number Is Necessary only ff a Homestead Deduction Is being flied) Signature of Buyer 2/Spouse 9/4/26 anted Legai.Name of Buyer 1 Sign Date (MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) Caleb Hardin Last 5 D lis `f Buyer 1 SSWDriver's License/ID/Other Number Last,5 Digits of Buyer 2/Spouse SSN/Driver's LicensefID/Other Number Page 3