HomeMy WebLinkAboutHomestead_Robinson (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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'Preparer of the Sales Disclosure Form Title
IROt' Mar n 54-• buboes —retie Co.
Address Number and Street) Company
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E-mail
iEI SEEL ER1S)%GRANT0R_(S) :za,rt rT c a2. -,;, 1`::Z.'fir. -� X3"1' '12-it: .7{2.t_. Al i.<r.::.-.X -21 z:'`4 ' .Ai `'
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Seller 1•Name as appears on conveyance document Seller 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
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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
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Sig re al Seller Signature of Seller- .ItI�ttlel AAO/ i t, 17-arrl s i-A1,-(3
Printed Name of Seller Sign Date(MMjDD/rYrt) Printed Name of Seller Sian Dote(MM/UD/Yn1]
iFABUYER�SJ%GRANTEE SJ APP.L'IGATION FOR`P,ROPERTA WPAXiDEDUGTION SIIDENTIRicAI:L�(TEMSetHAT APPLift—WW _: ;Aa
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Buyer I•Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
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Address(Number a d S-et) Address(Number and Street)
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City.State,and ZIP Code City,State,and ZIP Code
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E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
V ❑ 1.Will this property be the buyer's primary EEC ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0' 4.Solar Energy Heating/Cooling System
! resideancce,incl din county:
r..uvti ❑ 0" 5.Wind Power Device
Address(Number and Street) �j �'L��" ❑ []" 6.Hydroelectric Power Device
GfiSOT ❑ [,3' 7.Geothermal Energy Heating/Cooling Device
Ci ;State ZIP Code County
[j III 2.Does the buyer have a homestead in Indiana to be ❑ Q 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ It 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.
IKR) DIN Ohl Cr ,('ales disc.iocLuz' Not available in all counties.)
Address(Number and Street) alo_I4_I8- !Da -obO. 4 ?4 -ODD
City,State ZIP Code County
Primary property owner contact name 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
being fl d.)
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Si oatre ofBuyerl nature ofBuyer2/Spouse -
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Printed Legal Name of Buyer I Sign to(MM/o Printed Legal Name of Buyer 2 Spouse - Sign Date(M.M/DD/FYY1)
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Last 5 digits of Buyer l Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number