HomeMy WebLinkAboutHomestead_Brown (3)a
219 N. Hart St., PO Box 13
•Ires (Number and Street)
iceton IN 47670
1i0; State, and ZIP Code
Tine
Hall Partenheimer & Kinkle
Comp,tn•
E -mail
E. SELLER(S) /GRANTOR(S)
lop D Stoll
-Seller I - Name as mmears on amretvnec document Seller 2 - Nm))e as nppearsnn mnve tvnce document
105.1; Weber Drive
Address (Number awl Street) Addre.'s (Num&•r and Street)
Haubstadt. IN 47639
Chy. State. and ZIP Code Om State, and ZIP r+de
E -mail Tcleplume 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 p ed by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
x
S m are of Seller S(gnoture n /Seller
'lop, D Stoll 05 -10 -2012
Printed Nomeof Seller - _ Sian DntelMM/t1lil 111 _ Printed Nunre o) Seller Sinn Date OMI /!1D/nTTI
dtxumant
Addres (Number and Street)
and ZIP Golc
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR
mnve}vncedocument
dddre cc ( Number a nd Street)
Haubstadt IN 47639
Ci% S:utn, and ZIP Cole
�
FOR THIS PROPERTY. IDENTIFY ALL OF THOSE, THAT APPLY.
YES NO CONDITION
Q 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
105 S Weber Drive
Addres (Number and Street)
Haubstadt IN 47639 Gibson
City, State ZIP Cade Cnun9•
Q R 2. Does the buyer have a homestead in Indiana robe
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
216 S. Vine Street
Addres (Number mtd Street)
Haubstadt, IN 47639 Gibson
City, State ZIP Cole County
✓❑
❑
3. Homestead
. o at- Energy Heating /Cooling System
EJ
Q✓
5. Wind Power Device
❑
FV
6. Hydroelectric Power Device
Q7.
Geothermal Energy Heating /Cooling Device
❑
Q
S. 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.)
- 000.40t- 0 0
Paul F. Brown & Delores J. Broom
Pritnwy rn»pertp owner ronto,l none 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 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
bei filed.)
�vtoreafBuyerl Sill... . nfByrr_' /Slmare
h I F Brown 05-10 -2012 i Delores J Brown 05 -10 -2012
l Sian Datr(sw /un/n »1 Printed Le-gul Name of Bull 2 /Spouse Sign Date(MM/DDATM
Lid
Los! 5 digits of Buyer 1 Drivers State Last 5ecurih, Number , Lost 5 digit' of Buyer 2 1Spouse Driver's State Last 5 Digits ofSocial5ecurity
License /ID /Other Number Alumber License /ID /other Number �