HomeMy WebLinkAboutHomestead_Pollock. . � ... . .. . . .. _. . .. : � _ . _ , �•r
DONALD R. DOWELL. II REGIONAL MANAGER
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DIRECT TITLE INC
The Estate of Bar6ara Melson
Seller 1- Name ai appears on conveyanre dacumen[
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Address (Number ond Sbee[J
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SAler 2- Name as appears on ronveyance dacvmmt
Address (A'vmber ond Stree[)
Ciry, StatG and ZIPCOde
Under penalties of perjury, t hereby certify that [his Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e a$ required by law, and is prepared in attordance with IC 6-1.1-S.S, "Real Proper[y Sales Disclosure Ac[".
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S�gnaNreoJShcer SignomreofSrJler
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PROPERTYTAX
ronveyanredacvmm[
THE SALES DISO.OSURE FORM MAY
Q � 1. Will this property be [he buyer's primary �
residence? Provide complete address of primary
O� �� nc . i cQ q luding co�Sy:
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dQiric G� str�� T/✓� �/7�i 7 d
Ciry.SmteZlPCade Counry
� Q� Does the buyer have a homestead in Indiana [o be
vacated for this residence? If yes, provide
complete address of residence heing vaca[ed,
including county:
AdCr¢s (Numbel and Strre[)
Ciry.SmreZIPCode
EDUCTIONS=�IDENTIFYALLITEMS.THATAPBtY;. -��� �•`
Buyrl Z- Name as appears on ronveyanre dacvment
Addr¢s (Number and Street)
Ciry, Sm[e, ond ZIP Lode
Tefe haneNvmber
THIS PROPERN. IDENTIFY ALL OF THOSE THAT APPLY.
( COKD1770Y
1_0 n 3. Homestead
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Sys[em
5. Wind Power Device
6. Hydroelectric Power Device
7.GeothermalEnergy Headng/Cooling Device
8. Is this property a residential rental property?
❑ ❑✓ 9. Would you like to receive tax statements for this
proper[y via e-mail? (Provide contact informotion
6elow. Please see instruc[ions for mare tnformatlon.
Not avai(able in all counties.)
C{1as�o(a A /'� /�a� c�ir (d-�3a/•DO/ �
mnmc[name
Under penal[ies of perjury, I hereby certify [ha[ this Sales Disclosure, to the best of my knowledge and belief, is [rue, correc[
and comple[e as required by law, and is prepared in attordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Ad". (Note:
Spouse information, Social5ecurity and Driver's License/O[her numbers are not necessary if no Homestead Deducdon is
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Pnnhd Legal Name aJBuyer 2/Spouse
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