HomeMy WebLinkAboutHomestead_McPeekINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
..� . r� �.. .. n �.,s¢,rs-�. .4 ::� a} : �. �rx_*fS E;> 'r-' !LT:Ira -.a a' x� h?'�e'`�.:5
�D:�PREPARER� -�....:���.,,:,.�..i�''. .�- �r .�,:.,�-r �:- . �� -a,S..?es_.F ir n's�'.�...i_., _--e.`�'.i::.Wm,� ..�_. �,.
IANA C. HARPER CLOSER
Repora'�ofthe5afesDisclasureFarm Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES LLC �
Addreo' (Num6er and SveetJ Company
EVANSVILLE. IN 47708
E�mail
_
E.SEI.LERS'GRANTORSr. _ <�:r`s1� ��.af§:=��.`.��:..'± �+ryk:^�fE'i".�a.4S.S=Y"`.'z_rtr�'15i`?i�':� _:�,�.'c•�i?�+' -;'.p�'�;",�..
ROBIN GOLDBACH
Selle� I� A'ame as appears om m�veyonce dorumen[ Sel/er 2- Name as appears on conveyanre documen[
73A E. CTATE cTREET
AdCress (Num6er and Sbeet) Addrea (Number andStrtt!)
PRINCETON IN 47fi7f1
E�mail Tele honeNUm6er E�mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, [o the bes[ of my knowledge and belief, is true, correct
a/Q�d) c�plete required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Act".
' gn mreoJSelf'e�w`' Slgnao�reaf5eller
o�;n �o�c(hGC-l� i -3i-I�
PnntedNameo Seller SionDate MAI/OD PnntedNameo Selle� Si nDate MM/DD
"F.BUYERS�GRANTEES�.`APPLICATION'EOR`PROPERT.1'�TAk��DEDUCTIONS=IDENTtFYrALG�ITEMSTHAT,APPLY�4r!`'� �`�.+,•�;��-'�
ROBERTJ.MCPEEKJR.
Buyer 1- Name as appears on com�eyonce dxumene By�er I- Name as appears on ronveyan�e davment
211 E CLARK STREET
Addre's (Number and Svee[f Address (Number ond StreetJ
PRINCETON IN 47670
E-mail Te(e honeNumber E-mai/
TNE SALFS DISCLOSURE FORM MAY BE USED TO APPL1' FOR CERTAIN OEDIICI'IONS FOR THIS PROPERTI'. IDENTIFY ALL OF THOSE THAT APPLV.
5'ES �0 CONDITIO\ YES NO COAUITIO\
� � 1. Will this proper[y be the buyer's primary ❑✓ ❑ 3. Homestead
residence? Provide complete address of prima�y � � 4. Solar Ener� Heating/Cooling System
res' nc in ing c unty:
❑ QJ 5. Wind Power Device
�yd��mae� �asveey /, / ��� �G /���� ❑ 0✓ 6. Hydroelectric Power Device
f �-���-, ��� � ❑ 0✓ 7. Geothermal Energy Heating/Cooling Device
Ciry�,SmteZlPCade Counry
� � 2. Does the buyer have a homestead in Indiana to be � ❑� $� �s this property a residential rental property?
vacated for this residence? If yes, provide ❑ ❑✓ 9. Would you like to receive [au statemen[s for this
complete address of residence being vacated, property via e-mail? (Provide contact informapon
including county: below. Please see instructions for more in�armation.
Not available in all counties.)
Addr¢s (Numbe� md Street) LI
Cirv, Sra¢ZIPCade Counm �� ��� _ O�-� O• - OO /'� l��— o a
Pnmarypmpertyownerronraaname E-mail
Under penalties of perjury, t hereby cer[ify that [his Sales Disclosure, to [he best of my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disdosure Ac[". (Note:
Spouse informa[ion, Social Security and Driver's Lirense/O[her numbers are not necessary if no Homestead Deducdon is
' g f led.)
- I-�3
� a[ureo .ryerl Signauireo/B�yer2/Spouse
rT s�, -s -�3
PnnredLegalNameoJBvyerl SignWte[ww/onM�'�7 Pn'nudLegalNameo%Buyer2/Spouu 5(qn�are(uu/on/m'1'J
(
Num6er Las[ 5 d(qitt of Buyer 2/Spouse Driver's State Lost 5 Digits o%Social Securig�
License/ID/OtherNumber Number License/!D/OtherNum6er
�y�