Homestead_SpurrINDIANA SALES DISCLOSURE FORM SDF ID: Paee 2
D.PREPARER
Val J. Fleig Attorney at Law
Preparer ofthe Sales Disclosure Form Title
�5 North Ninth Street Val J. Fleig Law Office
Address (Number and Street) Company
Petersburg IN 47567 (
E -mail
E. SELLER(S)/GRANTOR(S)
William L Spurr If Estate. by Bernice Spurr Personal Ren
Seller I - Name as appears on conveyance document
Seller-2 Name as appears on conveyance document
3932 F St Rd 64
Address (Number arostreet)
Address (Number and Street)
Winslow IN 47598
City, State, and ZIP Code
City, State, and ZIP Code
(
E -mail
Telephone Number E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and Inplete as regmre by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
SignatureofSeller Y Signature'111er
RPrnicp Spurr Personal Rep[ s ntativ
Printed Nameos^- Sian Dore (MM16LI= Pin red Name of Seller Sion Date(ADI /DD
F. S GRANTEE S -A LICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
William L. Sou r II
B; I A'ameasappearson•- yaucedocament
Burer2 -Name as appears on conveyance document
v r et
Address (Number and Street)
Address (Number and Street)
^aHand City, IN 47660
v, State, and ZIP Code
City, State, and ZIP Code
E-mail
Teleahone Number Email
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
✓ ❑ 1. Will this property be the buyer's primary
❑
I ❑✓ ❑ 3. Homestead
residence? Provide complete address of pri r
I o ar nergy Heating /Cooling System
residence, including county:
rodPo�erDevice
dt S .lay Ctreet
❑ ❑✓ 6. Hydroelectric Power Device
Address (Number and Street)
Oakland City, IN 47660 Gibson
❑ Q 7. Geothermal Energy Heating /Cooling Device
❑ 0 8. Is this property a residential rental property?
Caty, State ZIP Code County
❑ Q 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ ❑✓ 9. 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.
Not available in all counties.)
��
Address (Number and Street)
City State ZlPCode County
Pnmary property owner contact name Email
Under penalties of perjury, 1 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 and Driver's License /Other numbers are not necessary if no Homestead Deduction is
ling fl
Signature ofBuyerl f Signature ofBuyer2 /Spouse
�ram I ,Rru rr II
Number
Lost Sdigits of Buyer 2 1Spouse Driver's State Lasts Digits of Social Security
License /ID /Other Number
Number License /ID /Other Number