HomeMy WebLinkAboutHomestead_SelbyINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
O:PREPARER ' :- . . . _. :> .- .
Dan L. Reeves Attomev
Preparero/the Sa/a Diulosvre Form Title
716 S. Main St REEVES 8 COCHREN
Addres(Nvmberand5tree[) �am��y
Princeton. IN 47670
E�mail
E. SELLER S GRANTOR S '
Marion B_ Kobersiein Sonia K. KoberstPin
Seller 1- Name ai oppeors on ronveynnre dorument Seller 2� Name as appears on ronveyance documrn[
1��6 WI�SOO AVP. innF �/I�SOf1 QVP
Addrus (Number and Stree[) qddrea (Number and SVeet)
�rinceton. IN 47670 PrincPton. IN 47670
Ciry, Smce, and ZIP Lode Ciry, Smte. ondl/PCade
E-mail
Under penal[ies of perjury, l hereby certify that [his Sales Disclosur o the best of my knowledge and belief, is true, correc[
and o tple[e as requ' •ed by law, and is •epared in accordance wi IC�6-1.1-5 ," eal Property S s Dis osure Act".
( e� 1 _..
Srgnamn (Se/ler SignoNreo(Seller
Marion 8 Koberstein n i nnm i
PnntedNameo(Seller Si nDalefMH oD Pnn[edNamea Seller SiunDate uH/oD
F. BUYER S GRANTEE S- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Melissa Kav Selbv
Buyer 1- Name as appears on conveyanre doavment Buyer I�,Vame as appears on ronveyance datumen[
208 Wilson Ave
Addrev (Nvmberond Stree[J Addrw (Number and Saee[)
Princeton. IN 47670
� Ciry, Smte, andZlPCOde Ciry; Smte and ZIPCade
E�mail Tele honeNumber E-mail
THESALFSDISCLOSUREFORMFIAYBEUSEDTOAPPLYFORCERTAI,YDEDURIONSFORTNISPROPER ALLOFTI105ETHATAPPLY.
YFS NO CO\DITION NO CO\DITIOY
❑,/ ❑ 1.14'ill this property be the buyer's primary �J ❑ 3. Ho
residence? Provide complete address of primary � 4. Solar Energy Hea[ing/Cooling System
residence, including county:
20A Wilson Ave ❑ Q S. Wind Power Device
Addrecs(NumberandSneeQ ❑ �✓ 6. Hydroelectric Power Device
Princeton IN 47670 Gibson � � 7. Geothermal Energy Heating/Cooling Device
Ciry, Smte 21P Lode Counry
J� ❑ 2. Does [he buyer have a homestead in Indiana [o be � ❑� $� �s this property a residentlal rental property?
vacated for this residence? Ifyes, provide ❑ ❑✓ 9. Would you like to receive [ax statements for this
comple[e address of residence being vaca[ed, property via e-mail? (Provide conmct informadon
induding county: 6elow. Please see instructions for more information.
205 6th St Not available in al! counties.)
Addr� (Num6er and Sveet) �1
Haubstadt,IN47639 Gibson p(�p-la o� -203 -�31�a�-o3�
Ciry.SrareZIP[ode Caanry
Rimaryproperry'ownerron�aa[name E-mail
Under penalties of perjury, 1 hereby certify that [his Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-11-S.S, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
bei �led.)
Signam oJBuyer] SignomreoJBwer2/Spoose
��elissa Kay Selhy aynnnoi i
SocialSecuriryNum6er' Las[SdigitsofBu}•er?/SpouteDriver's Smfe Las[SDigi6o�5ocia15ecurity
License/lD/0[herNumber Number Litense/l0/OlherNumber