HomeMy WebLinkAboutHomestead_NunnSDF ID:
Attorney No. 4759 -26
nue
W505 N. Church Street. PO Box 146 Law Office of Ray Orulev
Addre r(Number and Street) Company
Fort Branch, IN 47648
E-mail
_Cynthia S. Fllis
Wier 1 - Name as appears an conveyance document
1200 W. Marton Ant A3
Address (Number and Sheet)
Oakand city. IN 47660
City, Smte and ZIPCade
Seller2 - Nome as appears on conveyance document
Address (Number and Sheet)
City, Sm[e 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 complete �d-bv law and is prepared in accordance with IC 6.1.1 -5.5, "Real Property Sales Disclosure Act ".
Buyer 1
Smte and7JPCode
% —
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS
Q ❑ 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
126 N. Jackson Street
Address (Number and Sheet)
Oakland City, IN 47660 Gibson
City, Smte ZIP Code County
❑ 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:
Address (Number and Street)
City, State ZIP Code County
Signatumofseller
Buyer Z - Name as appears on conveyance document
Address (Numberand Sheer)
City, SbrK and ZIPCode
APPLY.
❑ 3. Homes
� 4. Solar Energy Heating /Cooling System
S. Wind Power Device
❑
❑6.
Hydroelectric Power Device
❑
❑d
7. Geothermal Energy Heating /Cooling Device
❑
Q
8. Is this property a residential rental property?
❑ ❑✓ 9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
01 -Coo. 9�G- 0
Primary property owner contact name Email
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 Act ". (Note:
Spouse information, Social Security an Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.) _ / / X
silaa & ere of Buyer I - I Signature ofBuyer2/Spouse
Printed Legal Name ofBuyer2 /Spouse Sign Date(MM)DDMM
IIJ
Last5 digits of Buyer l Driver's State Last 5 Digits ofSociol Security Number I Last 5 digits of Buyer 2 1Spouse Drivers State Last 5 Digits of5ocial Security
License/)D /Other Number Number License /ID 10ther Number