HomeMy WebLinkAboutHomestead_Robbins (2)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D:PREPARER -` �- � _- - ` _� -.°z. ?- -
Christa Kinqsburv Closing Manaqer
RepareroJNe Salo' Disdosure £orm TiUe
501 Main Sireet Bosse Title
Address(NUmbe(and5veet) .
E-mall
E.SELLER 5 GRANTOR S � � - - -� �- � -
I arrv W. BailPy Karen A_ 8ailey
Selle� 1- Name as apprars on <onveyanre docvment Seller 2� Name as appears on rom�eyante davmen[
iflA4 S Collins St same
Addras (Nvmberand Svee[) Addrgs (Nvmber and Streer)
Franr.isrn IN 47649
Tele honeNumber E-mail
Under penal[ies of perjury, I hereby certify tha[ this Sales Disclosure, to [he best of my knowledge and belief, is true, correct
and complete as requiRred by aw, and is prepared in acwrdance with 64.1-S.S, "Real Property Sales Disclosure Ac[".
oin.�,�i l.� I"J �[t�u.v� 9/` � cu.Pe.�.
Sig amreof5 ler SignamreofSelfer
Lar Baile� 09/26/12 Karen A Bailey 09/26/12
Pnbt¢dNameo Sellvl Si nDofe�AlM/DD/YYYi7 Pnn[cNNomeo Seller Si nDote�AiAl/00/YYYV)
F�. BUYER S GRANTEE S'-APPLICATION FOR PROPERTY�TAX DEDUCTIONS= IDENTIFY ALL ITEMS THAT APPLY `- - �
MartvW. Robbins
Buyul-Na e sappwrson[onv anredocvment ,^ Buyu2-Nameasappearsoncanveyancedacumen[
I 88 � � . � � (�.i,� _
Addras (Numberand Suret� Addras (A'umbe� and StrrelJ
�_,��;:s� ��► y-��q
Tele honeNumber E�mail
THE SALFS DISdOSURE FOIL'N MAY BE USED TO APPLY FOR [ERTAIY DHDOCfI0Y5 FOR THIS PROPERTY. IDE9TIFY dLL OF THOSE THdT APPLY.
VFS YO COYOITi09 4'FS YO COYDIT108
OJ ❑ 1. Will this property be the buyer's primary �✓ � 3. Homestead
residence? Provide comple[e address of primary � � 4. Solar Energy Heatlng/Cooling System
residence, including county:
�RRa S Collins St ❑ ❑✓ S. Wind Power De��ce
,lddras(NumberandSVeetJ . � ❑✓ 6. Hydroelectric Power Device
Frencisco IN 47649 Gibson � Q 7. Geo[hermal Energy Heating/Cooling Device
Ciry, Stare ZIPCade lounry
� �✓ 2. Does the buyer have a homestead in Indiana to be � ❑� $• �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ Q✓ 9� �vould you like to receive taY sta[ements for this
complete address of residence being vacated, property via e-mail? (Provide contoct informotion
including county: below. Please see instructions for more informadon.
Not available in al! coundes.)
Add�gs(Numberand5treet) � � � /� �� -/Q � � � / ��OO�
Ciry, Smte ZIPCade Counry
Pn'marypmperryownermnmc[nome E-mail
Under penalties of perjury, I hereby certi(y [hat [his 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 641-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not �ecessary if no Homes[ead Deduction is
being filed.)
<-y ��:� .�i'�"_-
SignaNrea�Boya] Signamreo(Buyer2/Spovse
�y W Robbinc 09126112
6ast5digiGSafBuyer2/SpouseDnver's 5tate Las[SDigitto/'SocialSecunty
License/!D/OtherNum6er Num6er Litense/ID/OlherNumber