HomeMy WebLinkAboutHomestead_McConnellINDIANA SALES DISCLOSURE FORM SDF ID:
B�ian K. Mahonev
Preparel o(rhe Salu Disclasure Form
^� Main Street P.O. Box 176
ress (Number and Street)
etersburg, IN 47567
Ciry, Smte, and ZIP Code
RLW Consiruction. 1 1 C
Seller I- Name os appmrs an ronveynnce doa+men[
Addrezr (A'umber and Stree[)
Title
Mahonev Law O�ce
Campany
E-mail
Sel/er 2- Name as appearr on conveynnce document
Address(NvmberandSVee[) '
Petersburg,�
Under penaldes of perjury, 1 hereby cerbfy that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and com�plQet�e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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SjgnaNreo/5 r ��\a( £ Signamreo/'Seller
R.,1, b„ L w„ I-I- �t c `'a'� /5� /�
�Name earsonronveyancedacument
1 Es0 N
(NUmberand5treet)
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conveyanndocumen�
THE SALFS DISCLOSURE FORM hL1Y BE USED TO APPLV FOR CERTAIN DEDUCI'IONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TFWT APPLY.
J 1. Will this property be the buyer's primar
residence? Provide complete address of
residence, including county:
Address (Number and StreetJ
Pike
Ci�rJZIP Code County
2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addrus(NumberandSVeet)
City, Smte ZlP lade
County
[_ 3. Homestead
❑ ❑�
❑ ❑✓
❑ ❑✓
❑ ❑✓
Heating/Cooling System
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
6elow. Please see instructions for more information.
Not availa6le in all counties.)
d � /�-a��� ���� 1� �U� �
Prfmarv uranerN ownar conmrt name f-mall
Under penaldes of perjury, i hereby cerdfy 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 with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Drivers License/Other numbers are no[ necessary if no Homestead Deduction is
being filed.) /� �
�,� ��.1�/!I (C;rr.��C/'� ��A.i..t?�. '� �JJ�C/;7)��,7�(�.
�/mre of Buyer7 -vg Signomre o/BUyer2/Spouse
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LostSdigitto%Buyer]Driver's Smte LastSDigitso%Social5ecurityNum6er LastSdigiGSO�Buyer2/SpouseDnver's Smte LostSDigitsa�5ocia(Securiry
License/ID/OtherNumber � Number License/(D/O[herNumber