HomeMy WebLinkAboutHomestead_Smith (51)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D:PREPARER
J. Robert Kinkle Aitomev
�Reparer o((he5ola Disdmua Form Title
219 N. Hart St.. PO Box 13 Hall. Partenheimer & Kinkle
Addras (Number ond Stree[J
E�mail
E. SELLER S GRANTOR S
MarilyII,�gP Pugh Jack R. Pu9h
Shcer 1- Name os a➢Pmrs on mmeyanre doaummt Seller? - Norne os appcvrs on rom�ryon¢ docvmmf
7137Narania ireet 7137 Narania Street
Addrets(Num6erond5<rxt) Addras(NumbcrandSmeet)
�phyrhillc FL 3';541-12R0 Zephyrhills FI 33541-1260
Ciry, 5<0[4 and ZIPCode Ciry,, Sm[e, and ZIPCode
E-moil
Under penalties of perjury, 1 hereby certify [ha[ this Sales Disclosure, [o the best of my knowledge and belie(, is true, correc[
and comple[e as required by law, nand is prepared in accordance w�ith I�C 6-1.]-5.5, "Real Property Sales Disclosure Act".
�'Iiz.u�.r ...,c�e� �/'�-r/t� >!'Q-cJt.<f'. ��
SignaNreo/5 e� �.9gn mreo/Seller
Marilyn�_p�h (1�2i /LU� Jack R. Pyyh Ji/Zi/2ei�
AinledNameof5eller SionDa[e1.VA/DD/YYYI'1 RinhdNameo/Sel(er Siqnibteluu/00/YIYrI
F. BUYER S GRANTEE 5-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Kimberlv J. Smiih
Buyer 1- Name as appears on ronvn�anre dotument Hueer 2� Name as appears on ronrryonae Jocvmm[
7023 E 250 S
Addras (NUm6er and StreelJ Addres> (Nvmber und5[rnrJ
Princeton.IN 47670
E-nmil Tele honeNumbrr E-mail
THE SALFS DISCLOSURE iORM �fA�' BE USED TO dPPL1' FOR CERTAI% DEUURIOYS FOR THIS PROPERTtl. IOEYTIfV ALL OF THOSE THAT APPLY.
YFS NO COSDITIOY YFS AO CO�DITIOR
Q � 1. l4�ill this property be the buyer's primary ✓❑ ❑ 3. Homestead
residence? Provide complete address of primary � � 4, Solar Energy Heating/Cooling System
. residence, induding county:
't07 N Sth Avenue ❑ Q 5. Wind Po�ver Device
Address(Nvmberand5heetJ ❑ ❑✓ 6. Hydroelec[�ic Power Device
Princeton IN 47670 Gibson � � 7, Geothermal Energy Hea[ing/Cooling Device
Ciry, Smte Z7P Code Covnry
QJ � 2. Does the buyer have a homestead in Indiana to be � ❑� $� �s [his property a residential ren�al property?
��aca[ed for this residence? If yes, provide ❑ 0✓ 9. Would you like [o receive [ax statements for [his
comple[e address o( residence being ��acated, property via e-mail? (Provide contact information
including counry: 6elaw. Pleose see instructions jar more in%rma[ion.
7023 E 250 S Not availaGle in all cowities.)
Addrets (Nvmber ond5her<J ] I
Princeton IN 47670 Gibson Kimber�y J. Sm�th r/`�D� `��_'�I _�I •��
[iry.SmreZl�[ade Caunry
Pn'map� proPerry ownermnma[ nnme E-mail
Under penalties of perjury, I hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance �vith IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Secu�ity and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filedJ
SigmNreafB r] SigmmreojBuyer2/Spouse
%a' a" O�`d//
I Number Lirense/lD/OtherNumber