HomeMy WebLinkAboutHomestead_Miller (2)INDIANA SALES DISCLOSURE FORM SDF ID:
PREPARER
Prepares ofthe Sales Disclosure Form
Address (Number and Street)
Attorney
Title
Hall, Partenheimer 8 Kinkle
Company
Princeton, IN 47670
E.
E -mail
Seller I - Name as appears on cnnve)vna document Seller 2 - Name as appears oo coaveyvnce document
12565 S 200 W
Address (Numberand Street) Address (Number and Streel)
Princeton IN 47670
City,
this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and( t-
c,omplete as required-by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
SignommofSeller Sigo.omeofSeller
Randall Thomas
-APPLICATION FOR PROPERTY T
Buyers - Na appears on conveyance document
514 S. 2nd Avenue
Address (Number and Stmt)
r & �
Address (Number and Street)
Princeton IN 47670
com'eyaruedocument
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
Q ❑ 1. Will this property be the buyer's primary
residence? Provide complete address of I
residence, including county:
514 S 2nd Avenue
Address (Numberand Street)
Princeton IN 47670 Gibson
City, State ZIP Code County
❑ F71 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:
Address (Number and Street)
❑✓
❑
3. Homestead
E
4 rgyHeating /Cooling System
❑
❑✓
5. Wind Power Device
❑
[Z]
6. Hydroelectric Power Device
❑
❑
7. Geothermal Energy Heating /Cooling Device
❑
Q
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
below. Please see instructions for more information.
Not available in all counties.)
a la--13 -1-7 -30Z- 0.00- q- I0J--o os
Jonathan E. Miller 8 Kern N. Miller
City, .State ZIP Code County Prue emmvner ranma name E -mail
Under penalties of perjury, 1 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 with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.)
Sig�Buyerl O r / - Signature 18 ler2 /Spouse
F Printed
Buyer l Driver's State Last 5 Digits of Social Security Number
License /lD /Other Number
KPrd N Miller '-f/a`�aol a-
P,inted Legal Name
Security
Number License /ID10ther Number