HomeMy WebLinkAboutHomestead_DawsonH. PREPARER !
Preparer of the Sales Disclosure Form
Title
Christa D. Tracey
Escrow Officer
Company
Southwestern Indiana Land Title
E-mail address Telephone number
christa@swinland.com
Address (number and street, city, state, country, and ZIP code)
(812) 425-0055
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
1. SELLER(S)/GRANTOR(S)
Seller 1 — Name as it appears on conveyance document
G&K Properties LLC, an Indiana limited liability company
Seller 2 — Name as it appears on conveyance document
Address (number and street)
AddreAs (number and street)
PO Box 8040
City, State and ZIP Code
Evansville, IN 47716 �
City, Staxe and ZIP Code
Country
United States of America
Country
Email Address Telephone Number
grantwaldroup@fcte.com (812) 664-7270
Email Address Telephone Number
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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.
Signature eller
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Signature of elIDW
Printed Name of S erDate; Signed (mm/dd/
Grant Waldroup, yyyy)
Printed Name o Seller Date Signed (mm/dd/yyyy)
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J. BUYER(S)/GRANTEE(S) — APPLICATIO ERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 — Name as it appears on c eya a c ment
Buyer 2 — Name as it appears on conveyance document
Tucker Dawson ISophia
Dawson
Address (number and street) �`,
Address (number and street)
308 N. Vine St. '�,
� �'
City, State and ZIP CodeAA
City, State an ZIP Code
Haubstadt, IN 47639
�O�
IN S
Country
Country
United States of America Gq
United States of America
Email Address G�6 elephone Number
(317), 903-7742
Email Address Telephone Number
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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
0 . ill this ropert be the bu er's rima residence?
0 ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
��2.Does the buyer have a homestead to be vacated for
this residence? If yes, provide address:
❑ 0 5. Wind Power Device
❑ 0 6. Hydroelectric Power Device
Address (number and street) j
i
❑ 0 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
(coo In
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 any information required to be provided, commits a Level 5 felony. (Note: Both spouse's information, SSN/Driver's
License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
Sigma nature o Buy 1
I
Sign ure of,Buy r 2/S ouse
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Tucker Dawson -A
Prin'tel Legal Name of Buyer 2/Spouse Sin Date (MM/DD/YY)
Sophia Dawson
Q)
Last qiits-nfR,1JgT 1 SSN/Dn_verice`/I`Q/ er Nu � cR2
Last 5 its of E uye 2/Spouse�SSaN/OLer"icen�e/ID 0 - ,uber
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