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HomeMy WebLinkAboutHomestead_HorrellC WQIANA SALES DISCLOSURE FORA SDF ID: Page 2 D.PREPARER Val J. Fleig Attorney Preparer of the Sales Disclosure Form Title North Ninth Street Val J. Fleig Law Office ddress (Number and Street) Company Petersburg, IN 47567 ( City, State, and ZIP Code Telephone Number Email E. SELLER(S)/GRANTOR(S) Martha L. Horrell Seller] Name as appears on conveyance document Seller2 Name as appears on conveyance documeor 402 W. Pike Avenue Address (Number and Streec) Address (Number and Street) Petersburg, IN 47567 City, State, and ZIP Code City. State, and ZIP Code ( E -mail Telephone 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 cg t letea*ey�d b y I��repared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". - Slgna1re of Seller Signature of Seller Martha L. Horrell Printed Name of$eller Sian Date IMMyDD/YYYY) Printed Name p Seffer Sian Date (MM /DD F. BL ' S1 - APPLICATION FOR DEDUCTIONS AND CRED] I IFY AL THAT APPLY Iartha L. Horrell Victoria L. Ross Buverl Name as appears onconv .,ce document Buyer 2- Name as appears on conveyance dog ment enue or on Address (Number and Street) Address (Number and Streer) Petersburg, IN 47567 Oakland City, IN 47660 ® E -mail Telephone Number Email TILE SALES DISCLOSURE FORM bIAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION x1 ❑ 1. Will this property be the buyer's primary ] ❑ 3. Homestead residence? Provide complete address of primary ❑ xD 1. Solar Energy Heating /Cooling System resilience, including county: ❑ f� 5. Wind Power Device 210 W. Morton ❑ 7x❑ 6. Hydroelectric Power Device Add,,.(NumberandStreet) Oakland City. IN 47660 ❑ �xx] 7. Geothermal Energy Heating /Cooling Device E) 8. Is this property a residential rental property? Ciry, State ZIP Code County ❑ 7x] 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide complete address of residence vacating, including county: _ ovo - Street) Address (Number and Ciry. Sm to ZIP Code County Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and co iplete re it y law, an s prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". ✓�� Sir.oture of Buyer i Signs cure ofBuyer2 Martha L. Horrell Victoria L. Ross Printed Name p Bated Sian Date (MMfDDIMY) Prin red Name p Buvert Sian Date lMM/DD/YYY11 V