HomeMy WebLinkAboutHomestead_MenyINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
P rIRER�
fDC-PRE
HRISTINA LATHAM TITLE CLERK
Pre parer of the Sales Disclosure Form Title
THEATER DRIVE REGIONAL LAND
�1703
Iddres's (Numberand Street)
E -mail
E. SELLER S' GRANTOR S :-
FARI JENKINSM
WANDA I EE JENKINS
Seller 1 - Name as appears on convevonre dFo
Seller 2 - Name as appears on conveyance document
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Address (Numberand Street)
Address (A'umber and Street)
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Under penalties of perjury, I hereby certify that this 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 ".
Signature of Seller �J \-�\� r� \� Signature of Seller `2 (lG
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EARL JENKINS JR WANDA LEE JENKINS
PrimedN er Sian Date(MM /DD Printed Name o Seller S "qn Dare fMM /DD
`F: ER S .GRANTEE S - PP.LICATION'FOR'PROPERTY TAX ' DEDUCTIONS- .IDENTIFY.ALCITEMS' THAT APPLYi
C)HN M NY
Buyer I- Name asappea onveyance documenr/Y
FJ
Buyer 2- Name as appears on conveyance document
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Address (Number and
Lz
meet) //
C1�L V I 76X6
Address (Number and Street)
Q
Telephone Number E -mail
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I Y cONDITION
❑ 1. Will this property be the buyer's primary
I Q ❑ 3. Homestead
residence? Provide complete address of prima
ergy Heating /Cooling System
e,�nclu county:
❑ Q 5. Wind Power Device
UAO �' +de�nc-
c�
❑ ❑✓ 6. Hydroelectric Power Device
Addre (gma�dspeet) - f C�
CC. �GtI CI
} �� O
❑ ❑ 7. Geothermal Energy Heating /Cooling Device
E] R] 6. Is this property a residential rental property?
ory, State ZIP Code County
❑ 2. Does the buyer have homestead in Indiana to be
a
vacated for this residence? If yes, provide
❑ ❑ 9. Would you like to receive tax statements for this
complete address of residence being vacated,
property via e-mail? (Provide Contact information
including county:
below. Please see instructionsfor more information.
Not available in all countie)
"N M MENY NA
Address (Number and Street)
Ciry, State ZIP Code County
Primary property owner contact name E -mail
Under penalties of perjury, I hereby certify that this 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 information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
bei Iled.)
Signaure ofBuyer2 1Spouse
/5(gnatureofBuyerl j Q
HN M MENY
'
Last 5 digits of Buyer 2 1Spouse Driver's State Last 5 Digits of Social Security
License /ID /Other Number I Number License /ID 10ther Number