HomeMy WebLinkAboutHomestead_BakerINDIANA SALES DISCLOSURE FORM SDF ID: Page 2
1D.P.REPARER:
Kristin Hunteman Closing Agent
Prepares afthe Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(NumberaudSuaat) Company
Evansville, IN 47715
E-mail
y
Jason Bryant
Brandy N Bryant
Seller I -Name as appears on conveyance document
801 W Elm St
Seller 2 -Nama as appears on conveyance document
801 W Elm It
Address (Number and Street)
Hauhgtn(It IN 47639
Address (Number and Streat)
Haubqtadt IN 47639
City, ad Code
E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and mp et s re u red bylaw, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Si �& afSeller Sign.tur,ofselig I
2:21
Ja QW3012011 Brandy N Bryant 09110/2011
P.ltedNmae.f Self of Sian Date (UN/DD/VTM Printed Name of&efler Sian Dute (scq1MM1',J
"F. BUYER(S)/GRANTEES )°' APPLICATION FOR PROPERTY TAX DEDUCTIONS= IDENTIFY ALL ITEM STHAT. APPLY--.
Caron L Baker
Cindy J Baker
Boyer I - Name as.ppears,m comeyamo document
Buyer 2 - Name as appears on conveyance document
480 E 12th St
480 E 12th St
Addrez (Number and Street)
Address (Number oudSrreet)
Flora. IL 62839
Flora, IL 62839
Email
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
❑ 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 `aunty:
❑ FZ] 5. Wind Power Device
❑ [Z] 6. Hydroelectric Power Device
❑ ❑ 7. Geothermal Energy Heating/Cooling Device
8. Is this property a residential rental property?
Cry. State ZIP Code Couny
El 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ [Z] 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 Sweet)
City, State ZhaCade county
I
Primarypropercvoumer comma name E-mall
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 and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being riled.)
--Zf
Signature ofBycrl Slgnaa.c of Buy 2/S sc
Ggron I Raker 0913012011 Cindy J Baker 0011012011
ofBoyer I SWnnate(MWDD/1Yvn p,7n � ofihy-21Svause Dote L
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Lost 5 digits of Buyer I Driver's State Lost 5 Digics, DfSaenial Security Number Last 5 digits ofBuyer2lSpouse Driver's State Lost 5 Digits ofSocial Security
License,111910ther Number Number LicenselID10ther Number