HomeMy WebLinkAboutHomestead_FoleyH.PREPARER
Preparer of the Sales Disclosure Form
Tille
Katie Felty
Escrow Officer
Company
Foreman Watson Land Title
Email Address
kfelty@fw-It.com
Telephone Number
(812 ) 909-4543
Address (number and street, dty, state, country, and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
1. SELLER(S)IGRANTOR(s)
Seller 1 — Name as it appears on conveyance document
Seller 2 — Name as appears on caiveyance document
Andrew Lee Anderson
Jamie Lynn Anderson
Address number and street)
Address (numbs An5 et)
City ate, and ZIP Gods
City, Stale, and ZIP Code
UJ2RSIfrj1 .�W; 7���
Country
Country
us
us
Email Address
elephane Number
Email Address o?
p l f
?Ia ) � 71-
Qt
Under penalties of perjury; I hereby certify this Sales Disclosure, to the best 61 my knowledge.and belief, Is true, correct, and complete as
required by law, end is prepared in accordance with 1C 8.1.1-fi.b. A person.who knowingly a1itl lntentlonelly fa{alfiee the value of franaferred
real property, or falsifies any Info' ation required to be provldeiL comxrJtJqJVel ti iblony..
Si nature o elle
:�l
rg
of Seller Date Signed (mMddtyaef
ai d NmoPrntedNa Seller Dale Signed (mnyddlyyyy)
19118/26
Andrew Lee Anderson 9/18126
Jamie Lynn Anderson
J, BUYER(S)IGRANTEE(S) a APPLICATIONI, FOR PROPERTY TAX DEDUCTIONS —I . DENTIFY ALL THAT APPLY.
Buyer 1— Name as it appears on conveyance document
Buyer 2 — Name as it appearsVUd nl
Lisa Foley
Address (number and st t)
Address (number and street)
S�
City, State, and ZIP Code t J
City, State, and ZIP Code aC[ p ry C
t Lo2U
Country
Country
us
us
Email Address
Telephone Number
Emad Address GIBBON C® UN
s Number
sunshineface6O@yahoo.com
(812 ) 598-4909
Pursuant to IC 6.1.1-12-44, the.8ales Dliclasure Form may be used to apply for certain deductlone: Identify all of ihase the apply.
YES No CONDITION
YES No CONDITION
1. WIII this property be the b.uyer's. prlinary
❑ ®
® ❑ 3. Homestead
residence?
® ® 4. Solar Energy Heating or Cooling System
r 5. Wind
[3Power Device
❑
® 2. Does the buyer have a hdmestead to be vacated
for this residence? if yes,. provide address:
❑ ❑ 6. Hydroelectric Power Device
❑ 0 7. Geothermal Energy Heating or Cooling Device
Address ( r
Co. Uwqi U
a
Under peneltles of perjury, i hereby certify thet this sales Disclosure, to the best of.my knowledge and belief, is trus, correct, and Complete,
as required by law, and Is prepared to accordance with iC 64.1-6.6. A person who knowingly and Intentionally faialfies the value of
transferred real property, or omits or falsities any information required to be provided, commltsa Level 5 felony. (Note, Both spouse's
information, SSMEirlyer's License.40101her Number Is necessary onry if $ Honlestend Deduction Is being filed.)
ature I Buyer 1
Signature or Buyer 2/Spouse
Printed a1 are of Buyer 1 Sign Data (MMWDIYY)
Printed legal Name of Buyer 2/Spouse Sign Date (iNIWDDIYY}
Lisa Foley 9/18126
Last 5 Digits of Buyer SSN/Driver's License/010ther Number
Last 5 Digits of Buyer 2ISpouse SSNMriver s Lirense/0101her Number
Last 5 of SSN: 51,79 q
Last 5 of SSN:
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