HomeMy WebLinkAboutHomestead_ArchibaldINDiANA SALES DISCLOSURE FORM SDF ID: Pa e 2
. ��
.�l�I' L°' � � .^ .� x-� -. 'F F o-M S:ie
iD:P.REPARER__�.r.-:_�. _i:���i..r=5c;. � "'-s�..-�r:-r-.^.W __e..:_�_�%5r-_�e+�.+_.'7�.�___. �__e.`��z�PS���=—`'
Charlene Saloietra Title Aaent
Preparer of the Safa Disdasure Form TUe
600 N Weinbach Suite 410 Foreman Watson Land Title LLC
Addresi (Num6er and Stree[) Cnmpony
Evasnville IN 47711
E-mai!
.' . . _'Y r�� 'R ���n ...��.� Y
=E:�SELI:ER S ' GRANTOR 5 .�.� � �.a.—,r.-.���_:�'?.� ?"�,� ��-r :�'T�..'�x;°�=;�-� -�,"- �:.-u : �==,`e�m a ==���°'k �s
Matthew.l Herrenbrur,k
Seller 1-,VOme as appevrs on mmeyance documen[ � � " Selfer Z- Name as app�rs an aonvevmre dxvmen[
� �"JZ �l( t �t�V�`� 1� - �� � �J 1-�LI�'Cl'U-1 ;�c�
Address(NumberandStree[ � dddrar(NUmberandSVeet)
�/1 ti�,�a,i1 �-2 � ���( �f'1"tZ�
pry,Sm[ andZlPCode Ciry.Sm[e.andZlPlode
\�
E-mail Tele honeNum6er E-moil
Under penal[ies of perjury, 1 hereby certify tha[ this Sales Disclosure, to [he bes[ of my knowledge and belief, is true, corred
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act".
,c��— i��--
Si naN�eofSeller SignamreojSeller
Matthew J Herrenbruck 06129/�2
Pnn�edNameafSdfer SianDaref.aM/nn Pnn[edNomeoiSMler SimDate HM/DOMVr1
;'Fe;BUYER S 'GRAiYTEE S =APP,CIC:ATIOY�F,OR�P,RORERT:};T:4X'DfiDUCT10NS=-�IDENTI$Y*i1LC+ITEMS'�THAT;AP.PLY��� �F%.,``-�7_ �'C
Brvan J Archibald
Buyer 1� Name as appevrs am m�vevan�e daaumen[ Buyer 2- Name as appears an tanveyance datumen[
1501 S Washin ton Ave
AAdress (h'umber and SRee[) Address (Number and Sbeet)
?dnceton.IN 47670
Ciry. Sm[G and7JPCade City. SmtG and ZIP lode
E-maif Tefe honeNumber E�mail
TNE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CER7.11.�' DEDUCfI0N5 FOR THIS PROPERTY. IDEYTIFY ALL OF THOSE TNAT APPLY.
YFS \0 CO\DRIOY I YFS YO CO\DITIOY
� � 1. Will this property be the buyer's primary ❑✓ ❑ 3. Homestead
residence? Provide complete address of primary � a 4, Solar Energy Heatin�/Cooling Sys[em
residence, including counry:
� J��� S. L�C� sh i� v�'o n Av e. ❑ 0✓ 5. Wind Power Device
4ddress(NUmberand5treet= ❑ ❑✓ 6. Hydroelectric Power Device
�j�p e 1. 6 O i o N � 0 7. Geothermal Enerny Heating/Cooling Device
Ciry,SmreLP ode Counry
Q 2. Does the buyer have a homes[ead in Indiana to be � ❑� $� �s this property a residen[ial rencal property?
vacated for this residence? If yes, provide ❑ ❑✓ 9� Would you like [o receive tax statemenct for this
complete address of residence being vacated, property via e-mail? (Provide contact information
induding caunty: below. Please see instruttions for more information.
Not available in all counties.)
Addras (Number and Street)
aio-ia-��-,�o ► o� 3 �-�� oa�
Ciry. Smce LPCode Counry
Pnmaryproperryoumerconlnttname E-mail
Under penal[ies of perjury, t hereby certify [hat this Sales Disclosure, ro the bes[ of my knowledge and belief, is true, corred
and [omple[e as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Proper[y Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
beingfiledJ �, A / !,/
c �/l�jn,,/l v�t.✓{M/�LGii/
SignaNre o(Buyerl SignaNre of Buyer2/Spouse
Rrvan I Arrh'halri O6/29/12
Pnnred olNameo(8 v] SignDare(MM/uo/m'l) PnncedLegalNameof8vyel2/Spouse SignUa@(MM/OO�TYYYJ
��� �� �
LastSdigiGSajBuyerlDrive/5 Smre LastSDigiGSOjSocial5xuriryNumber LastSdigiGSOfBuyer?/SpouseDrive/s Smte LastSDigiGra(SodalSecunry
Litense/!D/OtherNumber Number Lfcense/ID/OtherNum6er