HomeMy WebLinkAboutHomestead_KellyINDU\AS,�LESDISCLOSUREFORU SDFIU SDOID �22�83 Pa�e2
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Holly Perkins Closer
Prepnruo(NeSulaDisdmvreFarm Ttlr
202 N. Shadeland Avenue Hocker & Associates
Address(NUm6era�5treetJ - . Compony
Indianapolis, IN 46250-
Ciry•, Smle. andLPCOde Teleyhone A'umber E-mail
E.SE�CERS�GRANTORS3���;;';i.�.'��%� �.;-;i.�..__..�_rys��.r=''` ��-s-��`-.:''����.._�:. ..".�..`_.':';.,..r.. ..,_-�'..
The Secretary of HUD
Seller I- Name as a➢O�rs on mmeyance docummc Seller I� Name as appears m mmryance documen[
40 Marietta Street
Addrrs(,Vum6rro+dSVeeQ Addicsr(Num6erandSVee[)
Atlanta, GA 30303-
Ciry. State, andZlP Code Ciry. Sm[e, anJ7JPCade
E-mall 7deohoneNUmber E-mail
n e penalties t erjury, 1 hereby cer[ify that [his Sales Disciosure, to [he bes[ of my knowledge and belief, is true, correct
nd �C� mplete as uired 6y law, and_ _i_sp�p ged���C'cnoTESnce with IC 6-1.1-5.5, "Real Property Sales Disdosure Act".
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i nomreo/Shce � Signamreo(Seller
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' _ UYER S � GRA� E �S �; �APPWGATION'FOR�PROPERTYTeU DEDUCTI - ' �` -- �.ALC-IT6MS�THATAPPLY'"'_+-' �,.. -•�
Jason Kelly Sarah Kelly
Bvyer7.-Nameas mrsonrom�eyanreJotument Buyer2�Nameasa � anronveyoncetlxument
ntry Lane nVy Lane
AECrrs(NVm eran treetJ Addrecs(NUmberandSUeet)
Princeton, IN a7674 Princeton, IN 47670.
Ciry. Sm�e. end 21P Code Ciry, Smt4 ond ZIP Code
E-mail
TNE S.LLFS OISCLQSllRE FORM MAY BE USED TO APPLY FOR CERTAIN UEDURIONS FOR THIS PROPERTY. IDENfiN ALL Oi THOSE THAT APPL1'.
YFS KO COtiDITIOY I YES NO CON01T10\
XQ ❑ 1. Will this property be the buyer's primary� Q ❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
residence, including county: � �
594 S. COUNTRY LANE S. Wind Power Device
AEQres(.':umSrroMSMetJ ❑ Q 6. Hydroelectric Po�ver Device
Princeton, IN a7670 GIBSON � � 7. Geothermal Energy Hea[ing/Cooling Device
liry. Smte ZI➢COdt Counry
GI � 2. Does tne buyer have a homestead in Indiana to be � �$� �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ � 9� Would you like to receive [ax statemerts %r this
complete address of residence being vacated, property via e-mail? (Provide conmc[ in�ormotion
induding counry: below. Pleasesee instrucpons for more in(ormation.
� Not availnble in all counties.)
Add.esr (;lum6er ond SlreeQ
Ciry,SmreZIPCode Counry ��'// /�/�' �� • ��' a��
Pnmary proMm owm mnton name F-mail
Under penalties ofperjury, I hereby cerrify that this Sales Disdosure, to the 6est of my knowledge and belief, is [rue, correct
and tomplete as required by law, and is prepared in accordance with tC 6-11-S.S, "Real Property Sales Disclosure AtP'. (Note:
Spouse informa[ion, Social Security and Driver's License/O[her numbers are no[ necessary i(no Homestead Deducdon is
bein f�K6V �%L � � J�' X
ignoWreofB t � mreofBuyer2/Spvuse
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Las[SdigitsafBuyerlDrlver's Sm[e LastSDigieso�SocialSeruntyNumber Las[Sd�qi[so�Buyer7/SpouseDriver's Smre Las[SDigilsofSocialSecurity
License/1D/OrherNum6er � Number License/ID/OtherNumber