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HomeMy WebLinkAboutHomestead_Martin (4)I E -mail Tole hone Number Email THE SALES DI SCLOSU RE FORM MAY BE USED TO APPLY FO R CERTAIN DEDUCTIONS FO R TH IS P AT APPLY. YES NO CONDITION YES No CONDITION xJ ❑ 1. Will this property be the buyer's primary Q ❑ 3. Homestead residence? Provide complete address of pri ary eating /Cooling System residence, including county: ❑ 5. Wind Power Device 404 S WEST ST. ❑ © 6. Hydroelectric Power Device Address (Number and Street) Haubstadt, IN 47639 GIBSON ❑ ❑ 7, Geothermal Energy Heating /Cooling Device ❑ © 8. Is this property a residential rental property7 Cat'• State ZIP Code County ❑ 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 including county: below. Please see instructions for more information. Not available in all counties.) �'�- dl,3 -o6 -ion L �.s� -oa9 Address (Number and Street) City, State ZIP Code County PrMarypmPerry owner mrmrt hUme 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. f d.) �__ al M ?14 Si oJBuyerl Sgna.rrg8uyer2 1Spouse - Si,...es /1'I. MA /�t'/1 0I/alr /lot j Printed Legal Name q Buyer l Sign Date(MM /DD/Mi1 Premed Legal, Name of Buyer 21SPause Sign 0. te(MM/DD/IYYY1 � l Driver's State Last 5 Digats of Social Security Number Lost 5 digits ofBuyer2 /Spouse Driver's State Lost 5 Digits ofSocial Security License /I910ther Number Number License /ID /Other Number