HomeMy WebLinkAboutHomestead_SorgiusINDIANA SALES DISCLOSURE FORM SDF ID: 2012 Paae 2
D. PREPARER
� Sherri S Hudson ClosinQ P.gent
Preparero(the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address (Num6ei and Street) Company
Evansville, Indiana 47713 (
E-mail
E. SELLER(S) / GRANTOR(S)
Karan A.Thacker
Sel/er 7- Name as appears on conveyance document Seller 2- Name as appears on conveyance document
204 S. 5th Ave
Address (NUmber and Street) Address (NUmber and Street)
Haubstadt,IN 47639
City, Stafe, and ZIP Code City. Sfate, and ZIP Code
E-mail Telephone Numbei E+nail
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 AcY'.
�f.(L}'i!l fF �Q,�.'.d%'Jl
Siq at re of Seller Signature of Seller
Karan A. Thacker /0�;30Jj �
Pdnfed Name of Seller Sign Da(e (MM/DD/YYYY) Pnn7ed Name o7 Seller Sign Da[e (MM/DD/YriY)
F. BUYER�S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL ITEMS THAT APPLY
Jonathan D. Sorgius Brena K. Sorgius
Buyer i- Name as appears on conveyance document Buyer 2- Name as appears on conveyance document
11069 S. Windy Hollow Ct 11069 S. Windy Hollow Ct
Address (Numbe� antl Sfreef) Address (NUmbe� and Streef)
Haubstadt, IN 47639 Haubstadt, IN 47639
Ciry, State, antl ZIP Code
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERN. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 1. Will ihis property be the buyer's primary Ja ❑ 3. Homestead
residence? Provide complete address of primary p p q. Solar Energy Heating/Cooling System
residence,inGuding county:
- ❑ � 5. Wind Power Device
204 S Sth Ave.
Adtlress (NUmbe� and Streef) ❑ 0 6. Hydroelectric Power Device
Haubstadi, IN 47639 � Gibson � 0 �� Geothermal Energy Heating/Cooling Device
Ciry, Sta;e LP Code Counry ❑ 0 8. Is ihis property a residential rental property?
�1 � 2. Does the buyer have a homestead in Indiana to be � � 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact infoimation
address of residence bein vacated,}'�cluding county: below. P/ease see instiuctions formore infoRnation.
�'t 1,�� q<- I��' �� �A �Ll� A1 / ��- Not available in all counties.)
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Address (Number and Street) /1 1!�n p� � � � � - 31 �03 cro / Sg �' �a
�-� �` � �� (` 1 �� ��� '_� �u Y 1 PAmary prope�y o�mer crontact name �
City, Stare ZIP Code . County
Under penal[ies of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and
complete as requi d by law, and is prepared in accordance with IC 6-1.1-5.5, "Real roperty Sales Disclosure AcY'. (Note: Spouse
inform ion o a Security and Driver's LicenselOther numbers are nqt'i�ecessa no.Homestead Deduction is being filed.)
�—.-- �� ) V _ 1'�
ig re o_ � Slgnafure of Buyer 2/Spou //, 'l
Jonathan D. r ius '— (7— Z- Brena K Sorgius lU ��v� ��
Pnnf Legal Name of Buyer 7 Sign Date (MM/DD/YYYV) Pnnt Legal Name o; Buyer 2/Spouse S�gn Dare (MM/DD/YYYY
� �� / ��
Buyer 2 Dnvers Sa,e La515 Digits of Soaal Sewnty Num6er
�icense/ID/Other Number License/ID/Other Number