HomeMy WebLinkAboutHomestead_Robinson (10) INDIANA SALESDISCLOSURE FORM SDF ID: Page 2
S,DPREPARERT'a,f.T t-. `_ '- f i 'a._:x.-11— -` ;L v: __— .��.._- -- _ . .
,a . - .
Ray M.Drulev Attorney No.4759-26
Preparer of the Sala Disclosure Form Title
15 N. Church Street, PO Box 146 Law Office of Ray M. Drulev
•dress(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 druleveinsicihtbb.com
City,State,and ZIP Code Telephone Number E-mail
4SE1TLTER(S)/GRANTOR(S) _..:-. . 1_ _ }__�, . 7 i _ - -- -
IRL Rehab Group LI C
Seller I-Name as appears on conveyance document Seller 2-Nome as appears on conveyance document
1071 N Bicknell Road
Address(Number and Street) Address(Number and Street)
Wheatland IN 47597
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".
Si natu •of Seller Signature of Seller
IRL Rehab Group LLC 4/18/13
Printed Name ofSeller Sian Date(MM/VD/YYYY) Printed Name ofSeller Sian Date(MM/OD/YYYI)
E4 BU,YER(S2GR:ANTEE S) APP,L•ICATION FORIP,ROPERTI YgTAX^D ED.UG TIONSLIIDEN,TIF,YfA'LL,ITEMSrTHATrATP-LYr`` • &-_ .
snth.n W..- R•bin on
' - -•, eyvnce document Buyer 2-Name as appears on conveyance document
20W' C,a ►i/e Dr
Address(Number and Street) Address(Number and Street)
C4rmP-f it 62862—
'
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 Y . CO`. •
❑ 1.Will this property be the buyer's primary jV ❑ 3.Homeste..
residence? Provide complete address of primary ❑ IN 4.Solar Energy Heating/Cooling System
residence,including county: ❑ is 325 (- ; b'ienl� S.Wind Power Device
Ad._ess(Number and S•eet) ❑ 0 6.Hydroelectric Power Device
• " J a -e I • van ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP ode County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 12 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: eeilrstivete more information.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code unty A6 - id - 07 - a°j -000. /,1 y-D x32
Primary property owner contact name Eati 'f/
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 file ,)
•
Signature of Buyer] Signature of Buyer2/Spouse
.
Number License/ID/Other Number