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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