HomeMy WebLinkAboutHomestead_Jenkins (2)H. PREPARER
Preparer of the Sales Disclosure Form
the
Kane Felty
Escrow Officer
Co-pany
EmailA,ddra ss
TelNphowNumber
Foreman Watson Land Title
kfeity@�w�it.com
(812 ) 909-4 s43
Address (mrTiber and 511reet, city, state, country, and ZIP tom)
7412 Eagle Crest Blvd Evansville?, IN 4F 715
I. ELLER(S)IGRANTOR(S)
Seiler 1 - Name as it appears on conveyarim document
Seiler 2 - Nair to as appears on conveyance document
Laura Wallace
Address (number- and street)
Address (number and Sheet)
� j }
V �1 1 t L 4 Ll V t ��
City, State, and Z1P Code
City, State, and ZIP Code
Country CT
Country
us
us
Email Address Telephone Number
Email Address Telephone Dumber
laura-a.waUace83@gi-naii.com C�51-h &
Under per€aities of perjury, I hereby certify this Sales eisclosum, to the best of my knowledge and.beliel, is true„ correct, and cotrpwo as
required by law, and is prepared in accordarme with IC 6-1.1-b.5_ A person who knowingly and intentionally faleffim the value oftransfemed
real property, or om is or falsifies any Information required to be provided, commits a Leve16 felony.
s- f Seller
Signature of Seiler
�;*Md Name of Seller
Cale Signed (mmtddlyyyy)
Printed (dams of Seder late Signed (mriVdd,Nyyy)
Laura Wallace 19125/26
J. Buyr=R(s)IGRANTEE(S) - A1xpucATlow FOR PROPERTY TAX ClECUC'iIONS - IDEN t_
Buyer °I - Name as it appears on cr raveysnce document
Buyer 2 -Flame as it appears on Ye n do`u f.
Devon Jenkins
Address {number and street)
Address (number and street)
625 Seminary St
City, State, and ZIP Cade
City, State, and ZIP Code
Vincennes, IN 47591
Country
Countyus
us
Email Address
Telepb uie Number
Email address
devonjerikiris86@gt-naii.com
( 812-4681-0803
( )
Pursuant to IC 6-1_1-12-44, the Sales Disclosure Form maybe used to apply for mitain deductions. Idtentiayy ail of these that apply: -
YES NO CONDITION
YES NO CONi31TlON
1. Will this property be the buyers primary
❑ ❑
® ❑ 3. Homestead
residence?
❑ d 4. Solar Enemy Heating or Cooling System
Q ❑ 5• Wind Power Device
❑ 2, Does the buyer Inave a homestead to be vacated
for this residence? If yes, provide address:
❑ ❑ S. Hydroelectric Power DeAce
❑ Q 7. Geothermal Energy beating or Cooling Device
Address friumber and stra3m)
':A'
S e ME f)6u-
City, Siala, and ZIP Code V County
Under penalties of perjury, I hereby certify that this Stiles disclosure, to the best of my knowledge and belief, is true, correct, and complete
as required by law, and is prepared in accordance va" i£ 6-1.1ar_5_,A Berson who Knowingly and intentionally falsifies the value of
transferred real property, or arniis or falsifies any information required to be provident, commits a Level 5 felony. (More: Both spouse's
informadarr, SSMDri►*er's i.i£en"aDlOther Number is necessary only i€a Homestead Dedictio: r is being filet.)
s nature ofBuVe r I
Signature of Buyer 21Spouse
Printed Legal Name of Buyer 1 Sign Date (I4+ll M0[YY)
Punted Legal Name of Buyer 2/Spouse Sign fate (MWDD1YY)
Devon Jenkins 9l25126
Last b Digtts of Buyer 1 SSFIIDrver's LiconsellMther Number
Last 5 Digits of Buffer ZfSpouse SSWOriuers Licensc�ID/Oilter Plumber
Last 5 of SSN: q � a-
ILast 5 of SSN_
Fame 3