HomeMy WebLinkAboutHomestead_VaughtI�DIA\ASALESDISCLOSUREFORU SDFID SDOID 473100 Page2
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:D;Pi�EPARER-�. _ �: ` . ,.�_ :s, ' -�- °- . -< ;; ._�..- y��. r;°� 3 '` .`�° ..-i�- � ��:���' - . - -
Jackie Mitchell mgr
PreparerofMe Safa Omiosure Form ]S:Ir
927 W National Ave Aames TiUe & Closings, LLc
Address (Nurnber nnd Svta) Company
Brazil, IN 47834-
�E.SELCER 5 GRANTOR S `:.��' � � � . ' .- , . -. � - .� _. � �. . _._, .. � . . . � ..
Paui F Ellis by Richard D Ellis, POA
Sellrl I- Name m appmrs on mrrvqance daavmmt Shca2 - Name asaDP�n w+mmeyoxe drcurtrert[
211 Mill St
AGdress(,Yurt:6erand5treetJ Addras(NUmberorMStree[)
Hazelton, IN 47644
Gty, Srote. and LPCade Ciry, Smm, and ZIP Rode
iele huneNumM E-ma(I Tefe honeNum6e� E-mail
Under penal[ies of perjury, I hereby certiFy tha[ [his Sales Disclosure, to the best of my knowledge and belief, is trve, wrrec[
a complete as required by la� w, and.is prepared in accordanre with IC 64.1-5.5, "Real Property Sales Disciosure Act".
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SigrtaNrcof5eller SignamreofSe/le�
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F. BUYER S GfL1NTE =APPCICATION FOR PROPERTY TAXDEDUGTIONS; IDENTIFY� ITEMS THAT,APPLY ;
Robert W Vaught Kelly J Vaught �
Buyerl�h'omeotappearso m�e}anmdacvment Bvyer2�Nameasa0pearsonm ancedxvmml
Address mnbetandiheet) �Address(Xum6erand5veet)
Sullivan , IN 47882- Sullivan , IN 47882-
GrySm[t a�d ZIPCode
Tde honeNUm6rr Email Tcfe MneNumher E-mail
111E SALES OISCIAAfRE iORM MAV BE USEO TO APPLV FOR CERTAIN DEDURIONS FOR THIS PAOPER7Y. IDENfIFY ALL Of THOSE THAT APPLY.
YES NO CONDITION YFS NO CONDITI
❑X ❑ 1.iNi11 this property be the buyer's primary Qx � 3. Homestead
residence? Provide complete address of prima 4. Solar Energy Heating/Cooling System
residence,includingcounty: ❑ �
2005 E 3505 5. Wind Power Device
Addrea(NumbvandStrtetJ ❑ Q 6. HydroelecMc Power Device
Pnnceton, IN a7670 GIBSON � � y, Geothermal Energy�Heatlng/Cooling Device
Ciry:Smftll➢Cade� lounry
❑x ❑ 2. Does the buyer hare a homestead in Indiana [o be � 0 8� �s this property aresidentlal ren[al property?
vaca[ed fnr [his residence? If yes, provide ❑ Q 9• Would you�like mreceive tax statements for this
comple[e address of residence being vacated, property via e-mail? (Provide contactinformatlon
including coun[y: be(ow. Please see instructions for more in�ormodon.
1587 E CR 50N Not available-in all munties.)
Address (Nvm ber and Str¢el) / '1 nj��/7
Sullivan, IN 47882 SULLIVAN �/2 _�a - 33 '�v� � �QO• " � • � ��
Clry, Sm¢ ZIP Cade Counry y
Pnmarypropertyownermnmttname E-mail
Under penaltles of perjury, l hereby certify tha[ this Sales Disclosure, [o the best of my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no.Homestead Deduction is
being filed.) � �� � � `�
S�ignamreojBUYOI Slg.amreo/B rr2/S se
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Rin[edlqalNOmea7Buyrll SignDam(MM/oD/IVn] Pnn[NLegalNameo(Bvya2/Spauu SignDvtefM+r/➢D�'n'�7
�LastSd(gitso%BuyerlDmers Smte LastSDigitsofSacial5ecuriryNumber LastSdig(tsafBuyer2/SpouseDriveYs S[ute LastSD(qitto(Sotial5ecuriry
License/lD/OtherNumber Numtier License/ID/OtherNum6er
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