HomeMy WebLinkAboutHomestead_DeJesusH,PREPARER
Praparer of the Sales Disclosure Form Title
Milton Norman
Settlement Agent
Company
Email Address
Telephone Number
o et w Title, LL
orders@hometownbtles.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)MRANTOR(S)
Seller 1 -- Name as it appears on conveyance document
Seller 2 — Name as appears on conveyance document
Douglas W. Davidson
Jami Lytle
Address (number and street)
Address (numberand street)
1023 S Stormont St
1023 S Stormont St
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Princeton, IN 47670
Country
Country
us
us
Email Address
Tei® hone Number
( z) fe o 0676
Email Address
I
Telephone Number
( j2) 2.13=05
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my tcnowledge and hellef,.is true, correct, and complete as
required by law,.and is prepared in accordance with.iC 6-1,1-b.5. A person who knowingly and intentionally falsifies theValue of transferred.
real. property, omits or falsifies " ttgn.required to he provided; mits: aLadef 5 felony,
Signature of 11 r
lgnature of oiler
Printed Name of SeflAr
Date Signed (mm/dd/yyyy)
ted Name of Seller
ate Signed (mm/dd/yyyy)
Douglas W. Davidson
9 '
lami
Lytle
J:. 5lfYER(s)1GRANTEE(S) — APPLiCAT1ON FOR PROPERTY TAX DEDUCTIONS.— IDENTIFY ALL THAT APPLY
Buyer 1 — Name as it appears on conveyance document
Buyer 2 — Name as it appears nveyance document
ema do Beta c urt DeJesus
Address (number and street)
Address (number and street)
2120 Aston Ct Apt 4
City, State, and ZIP Code
City, State, and ZIP Code �,�
Princeton, IN 47670
Country
Country
us
10
Number
Telephone)4
Email Address SO/� Cp�Q
Telephone Number
fbetaln�urt622@gmail.com
(dress
3 �0
Pursuantfo IC.:15-1.1-12=44, .the.Sales Disclosure Form may be used to apply for certain deductions. Identify jlF a that apply:.
YES NO CONDITION
YES NO CONDITION
® 0 1. Will this property be the buyer's primary
12 0 3. Homestead
residence?
0 (fit 4. Solar Enemy Heating or Cooling System
O ® 5. Wind Power Device
o 2. Does the buyer have a homestead to be vacated
for this residence? If yes, provide address:
0 (0 6. Hydroelectric Power Device
Cl (0 7. Geothermal Energy Heating or Cooling Device
—7
Address (number and street)
City, State, and ZIP Code County
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the frost of my knowledge and.lielief, -is truo, 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,
transfe ed real pro erty, wr omits or falsifies any informationrequired to be provided, commits a Level .5 felony. (Note. Bofh spouse's
Info atlon "ve "Lice e/ID/Other.Number is necessary only lfa Homestead Doducddn ig being filed.)
Si lure of 1 /�
Signature of Buyer 21Spause
rinted Legal Name of B ' 'r 1 Sign Date (MM/DD1YY)
i
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
Fernando Betancourt " Jesus
Last 5 Digits of Buyer 1 SSVNvsr's License/IDlOther Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
0ICY
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