HomeMy WebLinkAboutHomestead_Curtis (6)FORM
Robinson & Associates
`Frrparer o(the So/a Dinlosure Form
�?53 N. Main Street
Address (Avm6erand Sveelf
Oakland City, IN 47660
Ciry, Sm[e. andZl➢COde
Brian Coomer
Selfer I- Nome as oyprors m ronvevance do[vmmt
3272 W. Hickory 5[reet
Address (Num6er and SRee[J
Princeton, IN 47670
Ciry, SmtG and 21PCode
Attomey at Law
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Robinson & Associates
,
E'-mai!
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Rebecca Coomer
Seller Z- Namt ot appevrs on ronveyontt docummt
32�2 W. Hickory SVee[
Address(NumberondSVeeQ
Princeton, IN 47670
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Under penal[ies of perjury, 1 hereby ce ' at Ihis Sales Disdosure, to [he bes[ of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared m accordance w� h IC Q1-S.S, "Real P�qperty Sales Disclosure Ac[".
f3..._ �` �-�� I�� /1 .oR ies l' en->-��
Signa[vreofSeller
Brian Coo
tedA'ameo Seller
F:BUYER(S)/GRAN1
Alvin L. Curtis, Jr.
� Buyerl�Nam�easa �'
� p�Street
Addresn (NUm6erandSVn
Princeton,IN 47670
�ip•, Sm[e, andZlPCOdr
THE SALES �ISCLOSORE FORM MAY BE USED TO APPLY
S�"�I —li
FOR
Rebecca Coomer
none
Bm�¢r 1� Name as oppears m ronvry•anre domment
Address (Rumber and SrteetJ
Ciry�, Smte, ond ZIP Code
FOR THIS PROPERTY. IDEITIN ALL OF THOSE THAT.IPPLY.
❑✓ ❑ 1.4Vi11 this property be the buyer's primary
residence? Provide complete address of prima
� � � re esidence, in�u�ling county:
�� ,u— i'
l�d`dress(fhm randSnn[] ���� O
\ :'
Ciry.Sw[e ZIPCa7e Counry
❑ ❑✓ 2. Does the buyer have a homestead in Indiana to be
vacated for [his residence? If yes, provide
comple[e address of residence being vacated,
including counry:
Addr¢s�NumberandSVntJ
Ciq', Sro[e 21PCOde
Counry
Q✓ ❑ 3. Homesiead
n n 4. Solar Enr�
�C�/ �/i
System
U U 5. Wind Power Device
❑ Q✓ 6. Hydroelectric Power Device
❑ Q✓ 7. Geothermal Energy Hea[ing/Cooling Device
❑ �✓ 8. Is this property a residenrial rental property?
❑ ✓❑ 9. Would you like to receive cax sta[ements (or this
propertyvia e-mail? (Providecontoct information
6elow. Please see instructions�or more information.
Notavailable in all counfies.)
I t
�-/�-o��oa-00%>�3-oa� -.
Fnmo7� property owner ronmrt name E-moi7
Under penalties of perjury, 1 hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure AcY'. (Note:
Spouse information, Social Securi nd river's License/0[her numbers are no[ necessary if no Homes[ead Deduc[ion is
being filedJ !�
� Q (r, , o
SignaNreofBuy. • ��' Signamreo/BUyer2/Spouse
'�'vin L Curtis, Jr.
�nn�en tega�,vame oj Hy�er 1 Sign Da�e ptv/noM»)
Los[Sdigltso(BuyerlDrirer's Smte LnstSDigltsof5oria15eturiryNumber
License/lD/Other A'um6er
PnntedlegolNomro(Buye�2/Spouse
Sign Dare (4M/DD/n'YY)
Last 5 digits of Buyer7/Spouse Dnver't Smte Lost 5 Digiu of Sociol5ecuriry
Number 6irense/ID/OtherNum6er