HomeMy WebLinkAboutHomestead_Willis (7)INDIANA SALES DISCLOSURE FORM SDF ID:
Page 2
D.PREPARERR
Ray M. Drulev Attorney No. 4759 -26
Preparer of the Sales Disclosure Form Title
(�5 N. Church Street. PO Box 146 Law Office of Ray Drulev
Mdress (NUmberandStreet) company
Fort Branch, IN 47648
City, State, and ZIPCode Telephone Number E -mail
E. SELLER(S)/GRANTOR(S)
Susan M. Croffiord
Seller 1 "Name as appears on conveyance document
6001 F Rohert St.
Seller 2 - Name as appears on conveyance document
Address (Number and Street)
Muncip. IN 47103
Address (Number and Street)
E -mail
Telephone Number 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 complete as required by law, and is prepared in accordance with IC 6.1.1.5.5, "Real Property Sales Disclosure Act ".
A-
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Signatureof5eller Signature of Seller
Susan M. Crofford 09/23/2011
Printed Nameo Seller Sian Date MM o Printed Namea Sign Dow (MMIDDIrYM
F. BUYERS GRANTEE S,= APPLICATION FOR PROPERTY TAX DEDUCT TIFY ALL ITEM THAT APPLY
Ashlev E. Lubovich
nathon A. Willi
Bvyarl - Name as appears on conveyance document
Buyw2 -Name as appears on ronve document
1200 W. Martin Street Apt,
1200 Feet Apt C -3
Address(Numberand Street)
Address (Number and Street)
akland City. IN 47660
Oakland City IN 47660
E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES, NO CONDITION
Q ❑ 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:
❑ S. Wind Power Device
995 N Polk Or
❑ 6. Hydroelectric Power Device
Address (Number and street)
Oakland City, IN 47660 Gibson
F-1 7" Geothermal Energy Heating /Cooling Device
❑ 8. Is this property a residential rental property?
City, State ZIPCode 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.)
atp -iy -/ F -air 1 teat U 1 o 0 7
Address (Number and Street)
City, State ZIPCode County
Pn'mary properryowner contact name E -mail
Under penalties of perjury, l 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, Soc' 1 Security and Drivel's License /Other numbers are not necessary if no Homestead Deduction is
b ing filed.)
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�Prfn�Name Sign Date IMM1D0/YY1'Y7 Printed Legal NameofBtyw 2 1Spouse Sign Date(MM/DDIY M
�BUye�
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Security
License1I010ther Number Number License /ID /Other Number