HomeMy WebLinkAboutHomestead_Maikranz (3)INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
�DTPPREPARER ;� (n4 � sg � amt?; 7 ,
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Mike Coon Vice President
Preparer of the Sales Disclosure Farm Title
3500 Deoauw Blvd Suite 1076 Eagle Land Title
0ess (Number and Street) Company
dnaoolis IN 46268
E -mail
HUn
Seller] -Name as appears on com, ancedocument
_ 40 MArrietta St
Seller Name as appears on conveyance document
Address (Number and Street)
Atlanta GA 30303
Addreu (Number and Street)
Clty State, and ZIP Code
City State, and ZIP Code
Telephone Number Email
Te/e hone Number E-mail
Unde ,penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and om leteas re ire by lawA and is repared in accordance with IC 6.1.1.5.5, "Real Property Sales Disclosure Act ".
t
r tore /er •//7 / /I Signature o(Seller
Mnte eo Scfl i nDate plmjpD Printed Name o Seller Stan Date FAWIDDATM
bF. YE� ;',GR�p'NiTEfi'S �= ?A`P,PISIGATION)F- OR�P,.RO. - X�DED, • 0�!S'; ADEN{ PIE, Y�: 4�liL" IIT�EMSTHATi %A`PP[fY�fr�;u.�;,�tq
, Q6 I J a LY W k rc r-
Bu• 1- Fmeasappearsonnve ncedocumen[
- Name as appears on conveyance document
A (Numberand Street)
`scn sib ��(7��
Address (Number and Street)
_ Will •
[e and ZlP de
City, Stote and ZIP Code
Tee E mall
Telephone Number &mall
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TH IS P ROPERT ENTI FY ALL OF TH OSE _T_HIILy,
YES NO CONDITION YES NO CONDITION
—E],
. Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of prima
Sol a mg /Cooling System
residence, i lu jt)g count,. t
IC J/ (
❑ Wind Power Device
El Hydroelectric Power Device
dress( meranSore J � n/ / (M
q o r l'
In [/ Geothermal Energy Heating /Cooling Device
ity SweZIPCa a County
❑� Is this
❑ Does the buyer ave a homestead in Indiana to be
property a residential rental property?
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 counties.)
O 1— 005. l &_7 — (v--)7
Address (Number and Street)
City,State ZIPCode County
Primary property owner contact name Email
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.)
"T e e/ uyerl ` Signature a /Buyer2 /Spouse
\Printed
Leal Name off? 1 Sign Date(MM/OD/YYYY) Printed Legal NameofBuyer2 /Spou3e Sign Date(MM/DD/YYY1)
Last 5 digits of Buyer l Drivers State Lost 5 Digits of Social Security Number Last 5 digits ofBuyer2 /Spouse Driver's State Last 5 Digits of5ocial Security
License /lD /Other Number Number License/1D 10ther Number