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HomeMy WebLinkAboutHomestead_Beckman • INDIANA SALES DISCLOSURE FORM SDF ID?._ s ,Page [bI REPARERL -- — — -- — — IF— �7 J. Robert Kinkle ' Attorney Preparer of the Sales Disclosure Form ' Title' ' - ,• .PO Bok 13,219 N. Hart Street • • Hall,Partenheimer&Kinkle Address and Street) - .Company -Pririceton, IN 47670-: . • •-8121386-0050 - - . • City,State,and ZIP Code Telephane Number E-mail Ei:SEL'LER(S)%GRANIT,oR(Sti - - _ -- - - . ':.---7---- .- Mona J Sermersheim - • • -Seller I-Name es appears on conveyance document Seller 2 Name as appears an conveyance document 800 Country Club Road Address(Number and Street) Address(Number and Street) I awrenceville-II '62439 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 as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". nom. illis.0•im ,t la;....... ./. .ir-/4r : 'o'1'7'-::CJA" Signaturearller' - I ' • ' - 1 - ' — `� _ Signature of Seller - Mona.l-Se hithheirn by phanie Stoneberge Printed Name ofSeller:•-- . .• . _ Sian Date(MM/DD/YYYI) - - Printed Name of Seller• - - • Sian Date(MM/DD/flu) Lt.B.UIYER(S)GRANT:EE(S)_%APPi.(CATIONjEOR}PROP,ERTYLTaDEDUCTIC!NS':ID.ENMIFY(AWTEMSzTHATt'AEP,C}T • m s 6 Beckma - - ,� ,, ome as appears an conveyance document Buyer 2-Name as appears on conveyance document 708 Orchard Road Address'(NUmbertad Street) Address(Number and Street) ' Huntingburg, IN 47542 Telephone Number ' E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES .. NO 'CONDITION YES n rn ION - 0 ❑ 1.Will this property be the buyer's primary .171 ❑ 3. Homeste residence? Provide complete address of primary ❑ . © 4.Solar Energy Heating/Cooling System residence,including county: 8171E 370 S ❑ IN 5.Wind Power Device Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Oakland City, IN 47660 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code - County [ . ❑ 2. Does.the buyer,have a homestead in Indiana to be El 8 Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Z 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. 708 Orchard Road Not available in all counties.) Address(Number and Street) •I Huntingburg,'IN 47542 Dubois James B.Beckman ei 4' /3.-.1 8- 900 -00.o•ELS a. -DO y City State ZIP Cdde - County .. _ .Primary preperty owner conct ta name 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 r - . •red in accordance with IC 6.1.1 5.5,"Real Property Sales Disclosure Act". (Note: Spouse information Social urity • d Drivers License/Other numbers are not necessary if no Homestead Deduction is / r{ L._ / . • ,nature ofBuyerl - - Signature of Buyer2/Spouse •.lamps B•Berkman (:3/2-Z/-7.&(j3 - • . ' Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Sec .ty License/ID/Other Number Number License/ID/Other Number