HomeMy WebLinkAboutHomestead_BrewerINDIANA SALES DISCLOSURE FORM SDF ID: Paee 2 r
.- D PREPARE WUU -ate
Robert Rossiano -Acient
Preparer of the Sala Disclosure Form Title
14 US Hwy 30 Bumet Title
Address (Number and Streer) company
Schererville. IN 46375 (
E -mail
-E-.�SELL E R (S) I G RA N TO R (S
Primacy Relocation LLC
Seller I - Name as appears on conveyance document
6077 Primacy Pka Ste 300
Seller 2 - Name as appears on conveyance document
Address (Number and Street)
Memphis. TN 38119
Address (Number and Street)
City, State. and ZIP Code
City, State, and ZIP Code
(
Email
Telep hone Number 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".
set IeL4htc-eLed I
Signature ofse Signature of Seller
Punted ftme.l'Seller Sign Date MM Da Pri.wdlkfa.e D
E' PROPERT.Y= TAXDEDUCTIONS� .IDENTIFYIAL91TEMSiTHATAPPLYP1--F --Ia-` 1'!
Cecelia C. Brewer
leyancedocument
vverl- Nameasappearso
Suyer2.jVame"Gppeaaonwnveyancedocument
1220 Begonia Cou
Addres;(NumbercuidSoreet)
Addres;(NumberandScreer)
-vansville, IN 47712
Ciry, State and ZIP lode
CftT State, and ZlPlade
(
E -mail
Tekp hone Number E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPJERTY.�jAlr APPLY.
YES NO CONDITION Y CONDITION
1. Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of primary
—
4. Solar Energy Heating/Cooling System
residence, including county:
5. Wind Power Device
y-of
yes
❑ [a 6. Hydroelectric Power Device
Address
'tfi:o,
Y
r i q--) � w 6iitose-
❑ 2) 7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
City, State ZIP Code V county
❑ Fo'] 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ [2] 9. Would you like to receive tax statements for this
complete address of residence being vacated,
property-via e:rnail? (Provide contact information
including county:
I- P1, 3 IF - -Pansfor more informan . on.
Not available in all counties.) -
Address (Number and Street)
a6- /y- /Ss- /641 oco 0,5007
City, State ZIP Code my
Primary property cavaer contact name E-raml
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
being filed.)
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SlgnaturealBuyerl Signature afBaycr-213p..
enpfin r. Brewer 0312512011
Printed Legal Printed Legal Name of Buyer 2 /Spouse Sign Dow (KNIODMIM
Last S digits of Buyer 1 Driver's State Last 5 Digits ofSocial Security Number Lost 5 digits cfftyer2lSpouse Driver's State Last 5 Digits OfSociol Security
LicensellE110ther Number Number License /ID /Other Number