HomeMy WebLinkAboutHomestead_MarketINDIANA SALES DISCLOSURE FORM SDF ID: Page 2
'Da PREPARER -
S HANNON LIBBERT MANAGER
preparer o /the Sales DisUosure Form Title
703 THEATER DRIVE REGIONAL LAND TITLE
Address (Numberand Street) Company
EVANSVILLE IN 47715
ChD; State, and ZIPCode Telephone Number E -mail
iE. 'SELL'ER S GRANTOR S ='
CHARI ES HOWARD FI I IS
SHARON JEAN ELI IS
Seller l - Name as appears on conveyance docum mr
SSeeller 2 - Name ps a pears on c nvevance document
1
ClA How "T �l7 %/e
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X165 DhG nP J��C
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Address (Number and Street)
(Number ard Street)
E s van vi ti'P TA/
CAddress
77-,5
1.J[� '/
GT,Stam,mdZlPCade I
Tele hone Number 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 complete as required by law, and ss prepared in accordance wI I 6- 1.1 -S.S, "Real Property Sales Disclosure Act ".
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&4L&a ;,�lnwvt L7 -n_a1W
Signature ofseller signature
_
CHARLES HOWARD ELUS 3-IS -Za // SHARON JEAN ELLIS
Printed Name ofSd/er Sian Date(MmmD Printed Name of Seller Sian Dow(MMmitlyYYYI
ER t EE S'=APPLICATION-FOR'PROPERTY, TAX• DEDUCTIONS- IDENTIFY.ALL- ITEMS :THAT:APPLY -. :' `-
DONNA J MARKET
Buyer 1 -Name as appears a veyvncedocuniew
Bower 2- Name as appears on eanvevunce document
UE
Address (Numberand Street)
Address (Number and Street)
IWKLAND CITY IN 47660
N�
city, State and Zip Code
Telephone Number E -mail
Telephone Number E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCr1ON'S FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
❑ 1. Will this property be the buyer's primary
[Z] E] 3. Homestead
7� residence? Provide complete address of primary
olar Energy Heating /Coo 'ng System
residence, including county:
❑ ❑✓ S. Wind Power e
110 N 3RD AVENUE
❑ [Z] 6. Hydroelectric Power Device
Address (Number and Street)
OAKLAND CITY IN 47660 GIBSON
❑ Q 7. Geothermal Energy Heating /Cooling Device
❑ ❑ 8. Is this property a residential rental property?
Ciry,Swtt 7JPCode County
❑ 2. Does the buyer have homestead in Indiana to be
a
I e 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 instructions for more information.
Not available in all counties.)
036-1.3-13 _ y ,0aoz ✓` 9 �(C07
Address(Numberandstreet)
DONNA MARKET NA
City, Smte ZIPCode County
Primary property owner conmc[name E-mail
Under penalties of perjury, l 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
'bein filed.)
'gnamre afBwerl Signature ofBwer2/Spouse
Printed al Name ofBwerI Sign Da[ plmlDD/YYYY) Printed Legal Name of Buyer 2 1Spouse Sign Dow(MMIDDIYYYY)
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Last 5 digits of Buyer l Driver's State Last 5 Digits of5ocial Security Number Last 5 digits of Buyer 2 1Spouse Driver's State Last 5 Digits of5ocial Security
License /ID /Other Number Number License /ID /Other Number