HomeMy WebLinkAboutHomestead_Williams (19)SDFID:
Karen Harbison
Preparero(the5ala Diulosureform
Addreu
�3Y��
Title
Elberfeld State Bank
Company
HaubstadilN 47639
E�mail
Jason R Ynchum
Seller 1- A'ame as appears on tanrryanre doavmml
Address (Num6er and Stree[)
Amanda R Yor.hum
Seller 1� Name as appenrs an convryanre dxvmen[
91AS230W
Addrev (Number and StreetJ
Under penalties of perjury, l 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 wi[h 1 M-1 1-S.S, "Real P' ope S le Disc osure At[".
. // � �.
S" a2�eo(Selle� SignaNreo/Seller
son R Yochu 05/25/2012
Address (Number and StreelJ
Smu, and ZIPCade
evytr z
Add�e�s[Numbe�andSVeeQ
Ft Branch.IN 47670
Ciry, Smre, and ZIPCode
THE 5�1LFS DISCLOSURE FORM MAY BE USED TO APPLV FOR CERTAI.Y DEDURIOYS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
COKDITION
0 ❑ 1. Will [his property be the buyer's primary f
residence? Provide mmplete address of primary
residence, including county:
Addrecs (NUmber and SvretJ
Princeton.IN 47670 Gibson
Ciry, Smte ZIPCade Counry
❑ 0 2. Does the buyer have a homestead in Indiana to be
vacated forthis residence? Ifyes, provide
complete address of residence being vaca[ed,
including county:
AdEres(NvmberandStreetJ �
Ciry, Smte LPCodr
Q � 4. Solar Energy Headng/Cooling System
❑ Q S. Wind Power Device
❑ 0 6. Hydroelec[ric Power Device
❑ � 7. Geo[hermal Energy Hea[ing/Cooling Device
❑ � 8. Is this property a residenrial rental property?
❑ 0 9. Would you like to receive tax sta[ements for this
property via e-mail? (Provide con[act in%rmadon
below. Please see instructions for mare informatlon.
�?[O - � - / �il . / D„i -DO/. $/ 5/- D,i ]
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 wi[h IC 6-1.1-5.5. "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deduction is
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SignamreofBuyerl SignaNreafBvyer2/Spouse
Amher Dawn Williams O5I95/9011
PnnteiLegalNameofBvyer7 SignDa[e(MM/DD/YYYi7 Pnn[
Las[SdigiGto(BuyerlDriver's Smte Las[SDigiGSO�SorialSecunryNumber Las[Sdigi[sa(Buyer2/SpauseDnver's 5[a[e LastSDigiaojSodalSecvriry
License/ID/OlherNum6er Num6er License/ID/O[herNumber