HomeMy WebLinkAboutHomestead_Thomas (14)FORM
ID:
Rav M. Drulev Attomev No. 4759-26
Prepvrer ofthe Sala Disdosvre Form 7yue
Law Office of Rav M. Drulev
Umpany
Fort Branch. IN 47648
Sd/er 1- Name as oppmrs on �onveyonre document Se11er2 - Name as appevrs on ronveyance document
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Add'en(NUmberand5tree[) .� „ � � /]� Addres(Numberand5bee[)
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E-ma�l Tele haneNumber E-mail
Under penal[ies of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as quired by law, and is prepared in accordance with IC 641-5.5, "Real Proper[y Sales Disclosure Act".
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Sgnom�eof5dler � 5{qnow�eo(Seller
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THE SALES DISCLOSURE f01A1 MAY BE USED TO APPLY FOR CERTAIN
Q � 1. Will [his property be [he buyer's primar�
residence? Provide complete address oA�nma
residence, m ding coun \
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ddras Numberand5tree
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l�ry, Smte LPCode Counry
� � 2. Does [he buye have a homes[ead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addrgs (Number and So-eer)
Ciry, SmteZlPCOde
Counry
as oppears on ronveyunce documen[
Addras (Number and Street)
Ctty, Smu, and ZIPCaCe
Tele h
�PROPERTY.IDE.YTIFYALLOFT TNATAPPLY.
YFS NO CONDITIOY
Q � 3. Homestead
� Q 4. Solar E eating/Cooling System
Q -�S. Wind Power Device �
� ❑�/ 6. Hydroelectric Power Device
❑ ❑✓ 7. Geo[hermal Energy Heating/Cooling Device
� Q 8. Is this property a residen[ial renWl property?
� Q 9. Would you like [o receive tax sta[emenLS for this
property via e-mail? (Provide contact informadon
6elow. Please see instrucdons for more in%rmadon.
Nat availa6le in all covnties.)
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Under penalties of perjury, i hereby certify that [his 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 informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being6led.) � �j �
�
Lirense/ID/O[h er Num6er
SignaNre o/BuyeR/Spouse
Pnnred Legal Nome oJBUyu 2/Spoute
Sjgn Date (MN/�D/YY1'1'f
LastSdigi[so(Buyer2/SpouseDriver's Sm[e LastSDigitso/Sacial5ecunry
Num6er License/ID/OtherNumber