HomeMy WebLinkAboutHomestead_AnslilngerINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
�:D?-PREPARER _ ._4.�� .�- � :+..._:��_...,�-���:`����3�_ z`�.=:= ��=�
Karen Harbison VP
Preparer o/Ne Sale D'¢dosvre Form Title
803 E State Rd 68 Elberfeld Siate Bank
Addreu(Numberond50-eet)
Ciry, Sraq and ZIPCade Telephone Number E-mail
.E�SEI:I:ER S -�.GRANTOR S _� -'.� .;�,. '�.,rs.=_�-�'�.,�_,._ .��._8L �.��-: -• �.�.:_ � _ . , �
Mark A Anslinger Heather K Weiss
SeOer 1- Name as aypears m conveyunce dorumm[ Shcer 2- Name as a➢➢ears om m�veyance drcemm[
2032 W 1000 S ?932 W 1000 S
Address (Nvmber and Sveet) Addrn's (Nvmber and Svee[J
HaubstadtlN 47639 NaubstadtlN 47639
Under penalties of perjury, t hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, is true, correct
' and comple[e as required by law, and is prepared in accordance with C 6-1 1-5.5 "Real Property Sales Disclosure Act".
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Signature o/Se!/er Signamre o/Seller
Mark A Anslinger 08/08/2012 Heather K Weiss 08/O9I20'12
PnnredNameof5eller Si nDace MMOU PnntedNameof5elfer Si nDare(wN oD
rF,>BUYER 5 GRANTEE S �e1P.P�IGATI0N+E0RiPROP.ERTY.:TAX-DEDUC-TIONS�IDENTIFY:�ALL?ITEM$tTHAT�AP,PGY�`'_ ��3 <� _��
Mark A Anslinaer Heaiher K Anslinaer
Buyer 1� Name os appears om m�veyanre drcumen� Bvye� 2- Name as appears m ronveyance documm[
2032 W 1000 S 2032 W 1000 S
Addras (NUmber and So-ee[) AdCress (Number and SveetJ
HaubstadtlN 47639 HaubstadtlN 47639
TNE SALFS DISROSURH FORM NAY eH USHD TO APPLY FOR CFRTAI\ DEDURIOAS FOR THIS PROPERTY. ID&\TIFY dLL OF THOSE THAT APPLV.
1'FS NO CORDITION I 1'FS NO C09DITI08
� ❑ 1. lVill this property be the buyer's primary 0 ❑ 3. Homes[ead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
residence, including county: � �
20't2 W t000 S 5. �Nind Power Device
Address(Numberand5trre[J ❑ � 6. Hydroelectric Power Device
Haubstadt IN .7639 Gibson � � 7, Geothermal Energy Heating/Cooling Device
Ciry, Smle ZIPCOde Counry
❑ ❑ 2. Does the buyer have a homes[ead in Indiana [o be � 0 $• �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ ❑ 9• Would you like to receive tax s[atemen[s for this
complete address of residence being vacated, property via e-mail? (Provide contoct informotion
induding county: below. Please see instructions for more informatian.
Nat available in alI coun[ies.)
Address (NUmber and 5[reeQ
a1 �-i Fs -35 -ioo 00 �. 36 3- o a S�
Ciry,SmteZlPCade Counry �
Pnmarypmpe�ryownerconmatname E-mail
Under penalties of perjury, l hereby cer[ify that this Sales Disdosure, to the best of my knowledge and belief, is true, corcec[
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduc[ion is
being filed.) '
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Signamreo(Buyerl Sigva�uyer2/Spouse
Mark A Pnsli�& r OAIOAI2012 Heather K Anclinger OR/ORI9019