HomeMy WebLinkAboutHomestead_Smith (38)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
.'D:PREPARER``; - . ; _ _ .
J. Robert Kinkle Attomev
heparer o/rhe Sa/u DBtlosure Form Title .
PO Box 73. 219 N. Hart Street Hall Partenheimer 8 Kinkle
Address(Numberand5vee[J Company
Princeton.IN 47670
lity, Slu[4 ond ZIP Lode Telephone Number E-mall
E: SELLER S .GRANTOR S � "r� '
.�a�ne A. Miller J. Michael Miller
Seller ]- Nome as appmrs on conveynnre docvmmt Seller 2- Name as appeors an conveynnce document
2169 N. 350 E. 9169 N. 350 E_
Address (Numberand Stree[) Address (NUmber and Stree[J
Princeton.IN 47670 Princeton IN 47670
.�/
E-mall
Under penaldes of perjury, I hereby cerbfy tha[ this Sales Disdosure, [o th b t of my knowledge and belief, is true, cortect
omplete/ a�s req�ired by la�v, and is prepared in accordance with IC 1 Property Sales Disclosure Act".
�i, L�- �' K�X I 1 ✓ . �
Sig eof5eiler Sig reo( elle
Javne A_ Miller �- � �' � �� � ��
Ai ea e er 51 nDatefMM DD PnntedNameo Seller an refM.4/DD
.BUYERS GRANTEE =APPLICATIONF,ORPROPERTYTAX.DEWGTIONS-.IDENTIFYACLITEMSTHATAP,PGY ° •
Teresa A. Smith
Buyerl-NOmeosappm mnveyancedacumen[ Buyer2�Nameasappenrsomm�veyanttdxument
1 s er Street
Address (NUmber ond StreetJ Address (Number and Sveet)
Fort Branch.IN 47648
E-mall Tele honeNumber Email
TNE SALES DISCLOSURE FORM FL1Y BE USED TO APPLY FOR CERTAIY DEDI1Cf10N5 FOR TNIS PROPERTY. IOENTIFY ALL OF THOSE THAT APPLY.
YFS NO CONDITION NO CONURION
� ❑ 1. Will this proper[y be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of prima 4. Solar Ene � ating/Cooling System
residence, including county:
2i6o N'�FO E ❑ ❑✓ 5. Wind Power Device
Address(NumberandStreet) � Q 6. Hydroelectric Power Device
Pnnceton IN 47670 Gibson � Q 7, Geo[hermal Energy Heating/Cooling Device
Ciry, Smte ZIP lade Counry
� ❑ 2. Does the buyer have a homestead in Indiana to be � � 8• �s [his property a residential rental property?
vacated for this residence? If yes, provide ❑ � 9• Would you like to receive tax statemenu for this
complete address of residence being vacated, property via e-mail? (Provide contact informotion
including county: 6elow. Please see instructions for more information.
104 E Foster Street Not availa6le in all counties.)
Add�ess(Numberond5tree[) �/ y^� t r/ ��D - OG l� sd���7
Fort Branch,IN 47648 Gibson Tere a R.Smith � T• T•
Ciry, Smte ZIP Code Counry
Pdmary properry owner conmct name E-mail
Under penaldes of perjury, 1 hereby certify tha[ this Sales Disclosure, [o the best of my Fmowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Drivers License/Other numbers are not necessary if no Homestead Deduction is
being filed.
��.ca.�� �tw�'�"l
SignaNre of Buyer SignaNre o(Buyer2/Spouse
Tarpca R Cmith oa-ii��3
PnntedLegalNomeo/Buyert SI,91IDafe(NH/DO/YYYI') PrintedLegalNomeo/Buyer2/Spouse SlgnDare(M.N/DD/YYYi)
Last 5 digiCS af Buyer ] Driver's S[ate Las[ S DigiCS of Social5ecurity Number Las[ S digiGS af Buyer 2/Spouse Driver's State Last 5 Digi� afSocial Security
License/ID/OtherNum6er Number Lirense/ID/OCherNum6er
�