HomeMy WebLinkAboutHomestead_KelleyINDIANA SALES DISCLOSURE FORM -SDF ID; • PaRe 2
V,
D. RREPARERn 1
Sherry Williams Title Officer
F
Preparer ofthe Sala Disclosure For. 7ule
&7090 Samuel Morse Dr., Ste. 400 Finiti Title, LLC
V Address (Number and Sweet) Company.
Columbia, MD 21046
City Score, and ZIPCode Telephone Nu.6cr E-mail
,EfSEIELER(S)/ GRANTORS ):
Michael R. Kelley, afk/a Mike Kelley
Seller Name as appears on conveyance document
Seller 2 -Name as appears on conveyance document
704 East Haub St.
Address (Number and Sweet)
Addras (Number and Street)
Haubstadt, IN 47639
City, State, and ZIP Code
City, State, and ZIP Code
Telephone Number E.moli
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 e a� re . d by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
,, Me
Signature Q(Scller
Sqnomre ofsellr i
If Il 9-2o-11
Printed Name ofSefter Sign Date (MMIDDIYYM Printed Name of5eller Sign Date (MMIDDIvITY)
F:,BUYER(S),1 GRANTEE (S) !,-APPLICATION FOR PROPERTY -TAX,DEDUCTI ONS-1 DENT] FY ALLITE MS-THAT—APPLY,,-
Michael R. Kelley
Buyer Name as appears an conveyance document
Buyer 2 - Name as appeou on conveyance document
704 East Haub St.
Add,mlNumbercedSwert)
Addrat; (Number and Sweet)
Haubstadt, IN 47639
City, State, and ZIP Code
City, State, and ZIP rode
Telephone Number E -mail
Telep hone Number E -mail
THE SALES DISCLOSURE FORI-I MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
F,-/l ❑ 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
704 East Haub St.
❑ ❑ 6. Hydroelectric Power Device
Address (Number and Sweet)
Haubstadt, IN 47639 Gibson
1:1 ❑ 7, Geothermal Energy Heating/Cooling Device
E] E] 8. Is this property a residential rental property?
City, State ZIP Code County
❑ n/ 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
below. Please see instructions for more information.
including county:
Not available in all counties.)
716 3 00 .9
Address (Number and Street)
City, State ZIP Code Counry
Primary property owner contact name F-awil
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 filed.
Signature ofB uyer2lSpo use
lL IQ. Y
Printed Legal Name ofBuyer I Son Date wmlowr" Printed Legal Name of Buyer 2 /Spouse Sign Date (MMIDDIn-M
Driver's Store Last 5 Digits of Social Security Number Lost 5 digits of Buyer 2 /Spouse Driver's State Last 5 Digits ofSocial Security
LicenselID10ther Number I Number License /ID /Other Number