HomeMy WebLinkAboutHomestead_BaizeH. PREPARER
Preparer of the Sales Disclosure Form
Title
Daniel A. Moon
Attorney
Company
Daniel Moon Law Office, LLC
Email Address
danielmoonlaw@gmail.com
Telephone Number
(812 ) 385-1843
Address (number and street, city, state, country, and ZIP Code)
111 N Hart Street, Princeton, Gibson County, Indiana 47670
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document
Seller 2 - Name as appears 99 conveyance document
Christine L. Baize
Address (number and street),
Address (number and street)
4316 W 200 S
City, State, and ZIP Code
City, State, and ZIP Code
Owensville, IN 47665
Country
Country
USA
Email Address
Telephone Number
Email Address
Telephone Number
(812 ) 779-4336
( )
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
rea ro erty, or omits or falsifies any information required to be provided, commits a Level 5 felony.
to of Seller
,
Signature of Seller
Printed Name of Seller
Date Signed (mm/ddlyyyy)
Printed Name of Seller
Date Signed (mmldd/yyyy)
Christine L. Baize
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDE T T. Y
Buyer 1 - Name as it appears on conveyance document
Buyer 2 - Name as it appears A co a nc c m t
John Baize
Address (number and street)
Address (number and street)
1542 S Old SR 65
OCT 1
City, State, and ZIP Code
City, State, and ZIP Code
Princeton, IN 47670
Country
USA
Country
GIBSON COUNTY'%
Ai IM,
Email Address
Telephone Number
Email Address
Telephone Number
(112 ) 3g6 /
Pursuant to IC 6-1.142-04, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION
YES NO CONDITION
Q O 1. Will this property be the buyer's primary
(?) O 3. Homestead
residence?
O Q 4. Solar Energy Heating or Cooling System
O OO 2. Does the buyer have a homestead to be vacated
O Q 5. Wind Power Device
for this residence? If yes, provide address:
O Q 6. Hydroelectric Power Device
O Q 7. Geothermal Energy Heating or Cooling Device
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Address (number and street) •
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
transferred real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony. (Note: Both spouse's
information, SSN/D vets Llcense/ID O her Number is necessary only /f a Homestead Deduction Is being filed.)
Signature of Buyer 1
7 •2 6
Signature of Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buyer 2/Spouse Sign Date (MM/DD/YY)
John Baize
Last 5 Digits of�Buy �rb1 S �/Driver's License/ID/Other Number
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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