HomeMy WebLinkAboutHomestead_Williams (33)I�DIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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LANA C. HARPER CLOSER
Reporero(Ne5algDisdosvreFOrm Title
�9 NW 4TH STREET STE 500 TOTAL TITLE SERVICES LLC
Addres(Num6erand5veet) Company
EVANSVILLE. IN 47708
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E: SELCER GRANTOR S •'. ._ . _ ° . - ,•" . , r ` . , - '. � ' :"'., x: . � :. `.. , , : s _. , .
KENNETH J. CO�LIS
Seller7 � Name as appears on ronveyanae davmmt Seller 2� Name as appears on canveyanre dxument
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dress(NUmberand5tr tJ Addr�(A'vmberand5vee[J
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Under penal[ies of perjury, 1 hereby certify Ihat Ihis Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and co� }� [e as required by law,/ id is prepared in accordance with IC 64.1-5.5, "Real Property Sales Disclosure Ac[".
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.F;�BUYER S GRANTEE S�:=APPLICATION'FOR-PROPERTf�TAkbHDUCTtONS�-'IDENTIFYALL`lTEh1STHATAPPLY�'� "' �" "'
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JEFFERY R. WILLIAMS TIFFANY D. WILIIAMS
Bvyer 1� /N�ame as appearson ronve'ya/nre dorume(n-t'/ 8y/�e�r/2�- Nom/e� asap/pe'a/rs/o�m m�veyanre dotummt
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E�mail
THE SALES DISCLOSURE FORM MAl' BE USED TO APPLY FOR CERTAI� DEDURIOKS FOR THIS PROPERN. IUE�TIF1' ALL OF THOSE THAT APPLY.
1'FS KO CO\DITIO\ � Np COAO 0\
✓❑ � 1.1Ni11 chis property be the buyer's primary �✓ � 3. Homestead
residence? Provide complete address of primary � 4. Solar Energy Heating/Cooling System
reSidence, ind ing county: � � 5.4Vind Power Device
�� � � � `�L N �t ❑ ❑✓ 6. Hydroelectric Power Device
ddres/tI1QNu 6erond5vee
��n"`' � ��� �� �" ❑ ❑✓ 7. Geo[hermal Energy Heabng/Cooling Device
Ciry.Smt Z/PRde Counry
2. Does the bwer have a homes[ead in Indiana to be � �$� �s ihis property a residen[ial rental property?
� vacated for this residence? If yes, provide ❑ ❑✓ 9• �Nould you like to receive [ae s[atements for this
complete address of residence being vacated, property via e-mail? (Provide contoct information
including county: 6elow. Please see instructions/'or more informadon.
Abt avai(a61e in all counties.)
Address (NUm6er ond Svee[J
�-�a-b�- �o� ooa. ���-oa�
Ciry, Sruu ZIP Cade Counry
Pdmarypmperryownerronlpaname E�mail
Under penal[ies of perjury, 1 hereby certify [ha[ this Sales Disclosure, [o the best of my knowledge and belief, is true, wrrec[
and comple[e as required by law, and is prepa,red in accordante �vith 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.
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Licente/(D/OtherNumber Number Lirense/(D/OlherNumber
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