HomeMy WebLinkAboutHomestead_PatelC�=
H. PREPARER
--.---------
Preparer of the Solos Disclosure Forn1
Title
Escrow Officer
Allyn Trasenriter
Email Address Tf+laphone Number
Corttpnny
Foreman Watson Land Title
ATRESENRITERQFVV-LT.COM (812 ) 909.4643
Address number and sif oat, city, sue, country, and ZIP Coda)
7412 Eagle Crest Blvd Evansville, IN 47715
_
I, SELLERS)/GRANTOR(S)
Sollor t •- Name ns ti appears on convoyaiico documenl
Seller 2 - Name as appears on canveynnca doctunont
Harry P, Sausser
Sanianitia Sausser
Address (number and street)
Address (number and s+roal)
21r134 Nwy 811
21434 Hwy 811
City, Slate, and ZIP Code
City, Slato, and ZIP Code
Reed, KY 42451
Reed, KY 42451 -- -
Country
Country
USA
Email Address Telephone Numbor
USA_ --
Emnil Address Telophono Number
psnusser rr outlooic.com (b14 ) 655-1504
1 samanthasausserftn1all-c0l" { 814 ) 655.1736
Under pbnalllos of perjury, I hereby certify this Sales Disclosure, to 1hs bast of illy krlowlecifia and I)ollef, Is true, corroci, and complete at•
knowhigly and Intentionally falsifies mo value of iransfoired
requted by law, And Is prepared In accordance with 10 a•1.1.6.6. A porson who
real property, or omlts or falsifies any Inforniallon required to lie provi(t rieonimlle a Level 6 felony. _
Sign It re of Sailor C
af-e fctNSS'�lr
0Fyn turo of Sal �+
< arna;lt, GA
f r
Printed Nano of Seller Date Signed (mmlddJyyyy)
P(Tided Narne of Sailor Dnte sic+ubd (nmVddlyyyy)
Harry P. Sausser 10101)1202G
Samlanlila Sausser _ -_ 10J01-112026
J. BEJYER(S)IGRANTEE(S) -APPLICATION FOR PROPERTY
TAX DEDUCTIONS - IDC Y LA. -THAT APPLY �-
[3uyor 1 -Nana as it appears on con documenl
Buyer 2 - Nan1e ns It nppoors o c av yanco do�un�dnt' .r
NElkumar A. Patel
Address (number and street)
Addross (number and street)
173_3 Indiana 57
-
ZIP Code
City, Stnto, and 7.IP Code
City, Slate, and
Oakland City IN 47600
County^
Country
USA
USA
f r+rni1
:puilAddess
(nher7dcress
O
Purou 1Ito IC 6.1.1-12.44, tllu�sales, Disclosure Fouli pray be used to apply for cot trill) do(Iuctlons. Ida nit IV all of thoso Ihat apply
YES No CONDITION
YEi NO CONDITiON
Homestead
1, Will tills property be tho buyer's primary
3.
0 res nce?
d 4, Solar Energy Healing or Cooling System
Does Ilia buyer have a homestead5.
to be vacated
Wind Power Device
r
� p
for tills residence? If yes, provide address:
0. Hydroolecirlc Power Dovlce
Adchoss (number anti street)
CJ fl 7. Geothermal Energy Healing or Cooliin-g�\4Davice
City, Slnto, nn(l ZIP Coda County
1C-` _'�- t-1 CD� ol�W - cm. -S0J� l
Under ponaliles of porju+y, I hereby certify that tills Sales plsclosuro, to Ilia best of illy knowledgo and belief, Is true, correct, rind coloptoto
knawingly find Intentionally falalliea the value of
as required by Jaw, anti Is proparod In accordanco with IC ti 1.1.6.1i. A parson who
trnneforracl rant property, or onilts or falsifies any hlfonriation required to be provided, cotliniils a Level 6101011y. (Mote: Boll? sJ)ouso's
tnlor+pafion, SSN/Drivor's LiconselVoftior Numbor Is nocessary only J1 a Ho+noslond Deduction Is fiolpd MOO _
Siynnhis u1 Dtryar t
Sig+udure of 1311yor wspouse
i�(inlod Legal Hania of Btlyor f Sign Drile (MMJl7DJYY)
f'rintod Lognl NOM. of 1:311yor 2y5pouso Sign Ua10 (hltrltE)DJYY)
Ni)kimiar A. Patel 101091202E
lest a Digits of Buy r i §SN1f)rivor`s LicensoJID/01her Number
_
La sl 5 D S a! f3tryor 2JSpouse SSfJJDnvor's LIL'ansrJlD101iu?r Niunbt?r
Last a of 5SiN: �p %
!last 6 aSSN:
f
Pa(10 3
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