HomeMy WebLinkAboutHomestead_Smith (9)11
H.PREPARER
Preparer of the Sales Disclosure Form
Title
LaToya Woodruff
Closing Agent
Company
Columbia Title, Inc
E-mail Address
(woodruff@columbiatitlegroup.eo
Telephone Number
'(812) 471-8563
Address (number and street, city, state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document
Seller 2- Name as appears on conveyance document
Shawn C. Spear
Robin R. Spear
dd ess (number an st eet)
Q. b vI �� �
Address (number and street),
��G Way � u J
City, State, and ZIP Code t.i /
AJf u /l0�,�C)
City, State, and ZIP Code
GiW.IN q(05
G0<try
Country
(EE--mail
E-mail Address
Telephone Number
Address
Telephone Number
shawn.spear1 @gmail.com 1
(812) 664-1701 1
rrspear0610@gmall.com
(812) 768-5389
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 pro a y, or omits or falsifies any information required to be provided, commits a Level 5 felony.
Signal r Seller //;
Si ur of Seller
'L 6111ot(
Printed Name of Seller Date Signed (mm/dd/yyyy)
Shawn C. Spear i}9Jp25 '�
Pnn ed Name of ftiler
Robin R. Spear-a/�
Date Signed mm/dd/yyyy)
.I. BUYERS)/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
Caleb K. Smith
Nicole L. Smith
Address umber and treet),
Address (number and stree )
zi
if
City, State, and ZIP PoM
irk/ 1a7
; t , Statean ZIP ode 6
, 64
countH
Countryy.
E-mail Address
Telephone Number
E-mail Address
Telephone Number
cks5685@gmail.com
(618) 615-1137
smsniki@aol.com
(812) 470-0328
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
❑ 3. Homestead
❑1. Will this property be the buyer's primary
residence?
❑ 4. Solar Energy Heating or Cooling System
5. Wind Power Device
Power Device
p� 2. Does the buyer have a homestead to be vacated
�,J ❑ if
for this residence? yes, provide address:
❑ 6. Hydroelectric
❑ [ 7. Geothermal Energy Heating or Cooling Device
Address (nu er and street)
f`ee
,�\ L L
r(
`: 1 am
City, St te, P co e, and County-
y b5 C
p
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true,
icorrect 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
jtransferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (No#e:
Both spouse's
informa 'on, SSN/Driver's License/ID/Other Number is necessary only if a Homestead Deduction is being filed.)
Sig urZfB!!! er
ig t of B kSizpuse/�.
Printed Le a Na a of Buyer 1 Sign Da a (MM/OD/,rYY)
in L g r 2/Spouse Si
n ate (MM/DD/YY)
Caleb K. Smith Jp �I13
Nicole L. ith
Q .
Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other umber
Buyer 2/Spouse SSN/Driver's License/ID/Other Number
Last 5 Digits Buyer2-3
C55
Page 3