HomeMy WebLinkAboutHomestead_SouthwoodINDIANA SALES DISCLOSURE FORM SDF ID: �, pa s 2
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CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND
Address (Number and Street) Company
EVANSVILLE IN 47715
E-mail
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CHAD A KINGSBURY SQURTNEY B KINGSBURY
Seller 1- Name as appears on conveyance document Seller2 - Name as appears on conveyance document
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Under penalties of e ju er r e•' that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and c let ' prepared in� accordance i IC 6-1.1-5.5, "Real Pr ertY S les Disclosure Act".
natureofSeller ' natureofSel(er
CHAD A KINGSBURY II, �IV I LJl 1- I� I���
Prin[ed Name o Seller Si n Date MM DD Printed Name o Seller Si n ate MM OD
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yer 1- Name as a pears on nveya e docu � Buyer 2- Name as appears on conveyance document
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A ess ber and Str et) � Address (Number and Street)
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Tele one Number E-mafl Tele hone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIIV DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES O CONDITION YES O CONDITION
� 1. Will this property be the buyer's primary � 3. Homestead
residence? Provide complete address of primary ��4. Solar Energy Heating/Cooling System
� residence, including county: 5. Wind Power Device
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ddress(Num6era Street) � � 6. Hydroelectric Power Device
� n `"' ���'� � ❑ � 7. Geothermal Energy Heating/Cooling Device
City,StateZ Code Counry �—y
� 2. Does the buyer have a homestead in Indiana to be � L��J Is this property a residential rental property?
vacated for this residence? If yes, provide ❑ L/J y 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.
Notavailablein all counties.)
Address (Number and Street) p� {p� �/ �� y a� QO 3��� ' Q a �%
CityStateZlPCode County �C SOiI ! ) �Ow�%�(ll.'v'�o� Iv'!Ya
Primary property owner contact name E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
a mplete a equired by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
pouse informatio , S ' ' and Driver's License/Other numbers are not necessary if no Homestead Deduction is
�ngfiled.) � i �%
�gnatureof 1 SignatureofBuyer2/Spouse
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Prinyed,
Last 5 Digits of Social Security Number Last 5 digits of Buyer2/Spouse Driver's State Last5 Digits of Social Security
License/ID/OtherNumber Number License/ID/OtherNumber