HomeMy WebLinkAboutHomestead_ChapmanINDIANA ::ALES
Preparer of lhe Salu Disdasvre Form
FORM SDFID:
Closing Services
rme
7820 Eaqle Crest Blvd. Suite 201 Reqional Title Services LLC
Addrr.a(Numberand5veetJ fnmpany
Evansville IN 47715
Harrod Development l LC
Sd/er 1- Name as appears om m�veyonre dacument
600 E Gtrain Ct
Addres (Number and S[ree[)
Fort Branrh IN 47648
Ciry, Smte, and ZIP Code
Seller 2� Name as oppeurs on ronveyance document
Addre.s (Number and Street)
Ciry. State, and ZIP Code
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and compl�as eq �re law, and is prepared in accordance with IC 6-1.1-5.5. "Real Property Sales Disclosure AcC.
��
��� u
Sjgnamrea(Selkr Signamrea/'Seller
Tnm Ha� crh"Id 11/07Y20�2
vd�rodN�,�en[Salla. SianDo[efMM/DOmYYI PrinredName
aacumen[
Addres (Number and Stree[)
Newburqh IN 47630
Ciry, State, ond ZlP Cade
Buyer 2� A'ame os appmrs on conveyance docummt
Addrpss (Number and StreetJ
Ciry, State, and ZlP Code
THE SALFS DISCLOSURE FORDf MAY BE USED T0.IPPLY FOR CERTAIN DEDUCf10N5 FOR THIS PROPERTY. IDEKfIFY ALL OF THOSE THAT APPLY.
�✓ � 1. 6Vi11 this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
40fi F Walrn t Ct
Addrea (Number and Street)
Fort Branch IN 47648 Gibson
City, Smte ZlP Code Counry
� ✓Q 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Addres (Number and Strret) �
Ciry, Smte ZIP Code
❑
❑
❑
❑
❑
❑
❑✓
�❑
❑�
❑�
❑✓
3 Ho� �
4. Solar Energy Heatlng/Cooling Sys[em
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/Cooling Device
8. Is [his properry a residential rental property?
9. Would you like to receive tax statements for this
property via e-mail? (Provide conmct in%rmation
6elow. Please see instructions for more information.
Not available in al cou '
-303 -000.8.25
E mail
Under penaltles of perjury, t hereby cer[ify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Drivers License/Other numbers are not necessary if no Homestead Deducdon is
beingfiled.) ,� , _ �
Lirense/!D/Other Num6er
Sign Da[e (MM/DD/YYYY)
Last 5 Digia of Social Securiry Num6er
Signature o(Buyer2/Spouse
Legal Name a(Buyer7/Spause
5(gn Da[e (MM/DD/YYYI]
LastSdigitsofBuyer2/SpouseDnver's Smte Las[SDigiaofSocial5ecuriry
Number License/ID/OtherNumber
y