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HomeMy WebLinkAboutHomestead_Page (2)H. PREPARER Preparer of the Sales Disclosure Form Title Company I Email Address i Telephone Number 11 Reoional Title Services of Jasper all ie.hildenbrand(dregionaltitlellc.com i ( 812) 848-2193 i{I (number and street, city, state, country, and ZIP 901 N. Newton St., Jasper, IN 47546 1. SELLER(S)/GRANTOR(S) Seller 1 - Name as it appears an conveyance document I Seller 2 - Name as appears on conveyance document Tiffany L. Lloyd II dre s rid str et Address (number and street) �,mbe Ity, State, . nd ZIP Code 410 ((Z City, State, and ZIP Gzfip Country I Country �WUNTY AUDITQH US Ep1 'ddress f, Telephone Number Email Address Telephone Number Under penalty+ of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete as required by I and is prepared in accordance with 1C 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. Sigrp* of Seller l I I Signature of Seller B Signed (mmidd/yyyy) Printed Name of Seller 1 Date Signed (mmiddly yyy) 09/28/2U 09128/2026 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 conveyance document i Kaitl nn Page I Colton M. Page dress (number and street) r E M N- Address (number and street) Lilr`? L1 no N City, State, and ZIP Code �,(J�m . I tM City, State, and ZIP Code L M IN Country Country us us Email Address Telephone Number i Email Address Telephone Number (812 )267-6252 i ( 812) 267-6252 I Pursuant to 1C 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 1. Will this property be the buyer's primary O 3. Homestead residence? i O % 4. Solar Energy Heating or Cooling System O M 5, Wind Power Device 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide address: O ® 6. Hydroelectric Power Device Q ® 7. Geothermal Energy Heating or Cooling Device Address (number and street) fats-o�-��,a ®©- (�QQ , DOl - CEO-i City, 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 I 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/010ther Number is necessary only Na Homestead Deducilon is being filed.) Signat re -of Buyer r of Buyer211Spo e /Signature i me Legal Narne of yer 1 Sign Date (MMiDD/YY) Printed Legal Name of Buye (Spouse Sign Date (MMIDD/YY) Kaitlynn Page 9/28/2026 Colton M. Page 09/2812026 f ILast 5 Digits o uy 1 Driver's License/IDiOther Number Last 5 Digits of Buyer 2/Spouse N rivers LicensellD/Other Number i f Page 3