HomeMy WebLinkAboutHomestead_Kohlmeyer (3)ISDI.\NASALESDISCI.OSURF,YORM SDFID SDOID 1388467 Page2,
D.PREPARER
Samantha Culsirger
/Teyare�o/NeSafes D'udosvreForm Titlt
226 W. Broatlway Broadway Title, Inc.
Addrm(Num6erandSVeefJ Campony
Princeton, IN 47670-
E-mail
E. SELLER S GRANTOR 5
Jose O Ibay Rosabel C Manalo-Ibay
Srqer 1� Nume vx oppean on wm�nrmie document Srller7 � Numr os np�rmn nn oonvewn�e da'umen�
914 Mohawk Dr. 914 MohavAc Dr.
AEdress (Number ond Sne<Q Addms (A'umMr and Ssttt�
Ft. Branch,IN 4764& FL Branch,iN 47648-
Ci.y,
E-mail Teie haneNUmMr E-n,oi!
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, is irue, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure AcC.
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. UYERS GRAN ES -APPLICATIONFORPROPERTYT DEDUCTIONS-IDENTIFYALL TEMSTHATAPPLY
Joshua A Kohlmeyer Shannon R Kohlmeyer
Bu�rr1�A'a . pcvrsonronveyanreduvmen: _ ' , -onmmewncedacument
9405 W 450 5 9405 W 450 S
. dress(NumbrranJSVertJ Addr¢s(Numbr�andStreeQ
Ovrensville, IN 47665 Ov+ensville, IN 47665-
F�mail
THESALESDISCLOSUREiORMMAYBEUSEOTOAPPLYFOACERTAINDEDUCtI0N5i0PTHISPN . TNOSETHATAPPLY.
Y'ES NO COVDITIOY Y'ES NO COROITIOY
Q ❑ t. Will this property be the buyer's primary / Q ❑ 3. Homestead
residence? Provide complete address of p lnary , rgy lieating/Cooling System
residence, including rounry: � �
9ta n70HnwK DR. 5. Wind Power Device
Address(NnmMrondStreetJ 6. Hydroelectric Power Device
Ft. Branch, IN 476a8 GIBSON � � 7, Geothermal F.nergy Heating/Cooling Device
Ciry, Sru:e ZIPCoCe Counry
x❑ ❑ 2. Does the buyer have a homestead in Indiana m be ❑ Q 8. Is this property a residential rental properry?
vacated for this residence? If yes, provide ❑ Q 9. 4Vould you like to receive tax statements for this
mmplete address of residence being vacated, p�'operry via e-mail? (Provide contnct in%rmotion
induding munty: below. Please see instrucnons%r more in(orma[ion.
sa05 w a50 S R'ot available in all counties.J
Addrets /NVmber onASmtJ ���111
Owensville, IN 47665 GIBSON �_ � /9/� /O/ �//� _ ��p
CirySm[eZIPCWe Counry R—�
/'nmarv properry owner mnmc� nume E�mail
Under penalties o(perjury. I hereby certify that this Sales Disclosure, to the best o(my knowledge and belief, is trve, correct
and comple[e as required 6y law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Proper[y Sales Disclosure Act". (Note:
Spouse in(ormation, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deducdon is
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