Loading...
HomeMy WebLinkAboutHomestead_Anderson (2)H. PREPARER Preparer of the Sales Disclosure Form Title Christa D. Tracey Escrow Officer Company E-mail address Telephone number Southwestern Indiana Land Title christa@swinland.com (812) 425-0055 Address (number and street, city, state, country, and ZIP code) 605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 I. SELLER(S)/GRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document Dorothy E. Wallace Address (number and street) Address (number and street) 3843 E 700 W City, State and ZIP Code City, State and ZIP Code Owensville, IN 47665 Country Country United States of America Email Address Telephone Number Email Address Telephone Number 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. i nat of Sell r Signature of Seller Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy) Dorothy E. Wallace yyyy) 9/9/2026 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 n ce Andrew Anderson Jamie Anderson Address (number and street) Address (number and street) CC'P �C 3843 S 700 W 8993 S State Road 165 l Q City, State and ZIP Code City, State and ZIP Code Owensville, IN 47665 Poseyville, IN 47633 Country Country QUIV coo"" /v7-y United States of America United States of America q Email Address Telephone Number Email Address Telep one Number (812) 431-5537 (812) 664-4468 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 z ❑ 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead ❑ 0 4. Solar Energy Heating or Cooling System El2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: ❑ Q 5. Wind Power Device ❑ Z 6. Hydroelectric Power Device Address (number and street) 4996�3 5 S ; I �S ❑ d 7. Geothermal Energy Heating or Cooling Device Cit , 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�Aqriy information required to be provided, commits a Level 5 felony. (Note: Both spouse's information, SSN/Driver's License/iD/Other Numbe n essa a Homestead Deduction is being filed.) Signature of Buyer ig of-Br§r Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY) P ted Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY) Andrew Anderson 9/9/2026 Jamie Anderson 9/9/2026 Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number SSN: dl-1.-Z-7 Co �) If -A ® 406al SSN: (D.© O gZ 1C> —# IJJ ® — I'S' Page 3