HomeMy WebLinkAboutHomestead_BaileyINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2'
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Samantha Cuisinoer
Aeparero(NeSafa D'udmure Form Tirle
I 226 W. Broadwav Broadwav Title. Inc.
Addrecs (Number and Svee[J Campony
Princeton.IN 47670
E-mail
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Randall E. Thomas
Se/fer 1� Name as appmrs an ronveyance documen[ Seller 2� Nome as appmrs on ronvryonce dacumen[
125R S ?00 W
Addr¢s (Numbrl and Svee[J Addr¢s (Nvmber andStree[)
Princeton IN 47670
Ciry, Smtt ond ZIPCade Ciry, Smtg and ZIPCode
E-mail Te/e honeh'umbrr E-mail
Under penal[ies of perjury, 1 hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, is [rue, correc[
and comple[e as re uired by law, a repared in accordance with IC 6-1.1-5.5, "Real Property Sales Disdosure Act".
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SignaNre o(Seller SignaNre o/Selkr
Randall E Thomas � I �I2070
Pdnf4dh' lt( SipnDate MM/OD PriOlGdNameo Shctr Si nDafe MN/OD
:: BUYER S' GRAN S �'APBLIGATION�EOR'.PROPERTYrTAX,DEDUCTIONS= IDENTIF,Y%AtG l'fEMS.THAT,APP.LY�'±%� k^ ' 4,s�:, t:c°
Andrea P. Baile
Buyvrl-Nameaso aonronveyanredacumml Buyc2-Nameasoppearsonronveyoncedotvmmt
233 uffman Rd.
Addres (Nvmberand SvmQ Addros (Number ond Street)
400nville IN 47601
:iry, State, andZlPCode Ciry, Sw[g and ZIP lode
E-mail Tde honeNumber E-mvil
THESALESDISdOSUREFORM�fAYBEUSEUTOAPPLYFORCERTAi9DEDURI0N5FORTH .IDENTIFY i TNOSETHATAPPLY.
YFS NO WNDITIOY YES NO CONDITIOY
JQ � 1. Will this property be [he buyer's prima Q ❑ 3. Homeste
residence? Provide complete address f prima ,/ _g nergy Headng/Cooling System
residence, intluding county:
527 W. Pinkney St. ❑ ❑� S.WindPowerDevice
Addras(Numherand5treet) ❑ J❑ 6. Hydroelectric Power Device
PTiilCeton, IN 47670 Gib50ri � � 7,GeothermalEnergyHeadng/CoolingDevice
Ci.y, 5[ote ZIPCode Counry
� �2. Does the buyer have a homestead in indiana to be � �� 8. Is [his property a residential rental property?
vacated for [his residence? If yes, provide ❑ LJ 9� Would you like to receive tax sta[ements for this
comple[e address of residence being vacated, property via e-mail? (Provide contact injormo[ion
induding county: 6elow. Please see ins[ructions for more information.
Not available in all tounties.J
Addr¢s (Numberand5vre[J �� _ �a _ o�> 3 d�- oo/ aG G- o ap
Ciry,SmteZlPCode Cavnry
Rimaryproperryawnerronmamome E�mail
Under penalties of perjury, I hereby certify tha[ [his Sales Disclosure, [o the bes[ of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance with IC 6-L1-5.5, "Real Proper[y Sales Disclosure Act". (Note:
Spous 'nforma[ion,�cial Security and Driver's License/O[her numbers are no[ necessary if no Homestead Deduc[ion is
bein . led )
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SgnaNre oJBuyer7 SignaNre o/Buyrl2/Spouse
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LastSdigi[so�BuyerZ/SpouseDnver's Smte Las[SDigiuoj5otial5etunty
Lirense/ID/O[herNumber Number License/ID/OlherNumber
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