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Homestead_Beach (4)
INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1768239 Paget Peggy A.Ralston Title Assistant Preparer of the Salo Disclosure Form Title 3101 N.Green River Road Suite 130 Trustworthy Land Title Co.,Inc. Address(Number and Street) Company Evansville,IN 47715- 812-471-8563 pconner @twtitle.com City State and ZIP Code Telephone Number E-mail E.SELiCER(S)/GRANTOR(SJ ,_ - .-, • - -;. -. . Rex A.Beach _ Seller I-Nome as appears on conveyance document Seller 2-None as appears on conveyance document 810 E.Oak Street Address(Number and Street) Address(Number and Street) Princeton,IN 47670- -- Telephone Number E-mail Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and corn r lete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". �� Sign Seler Signature of Seller 1 DI.adv.. 11*i3 Pn-.rot n ma nrc.ner Oar On'e r,.a tan 4\w. ty'ntM Nn•••r r'Srnrr ci-,o-,r O,Vm - SP - Y- - 'F.:BUYEfS)/GRANTEE(S) APPLICATION.FOR,PROPERTYTAXDEOUCTIONS-IDENTIFY,ALLTEMSTHATAPPLY •- • - Tr C.Beach E D Buye merl-Name as appears on conveyance document Purer 2-Name as appears on eon m u ear 2370 E.Carithers Road Address(Number and Street) Address(Number and Street) Princeton,IN 47670- MAY 6 2013 Telephone Number ialir-i- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL to = 4 . ''AUDITOR tE YES NO CONDITION I YES NO CONDITION tll.11 © ❑ I.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ 748 MAIN STREET 5.Wind Power Device Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Princeton,IN 47670 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code 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 ❑ © 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.) Address(Number and Street) jC,-,a-oil-3o4- ODD 130-Dag City State ZIP Code County Primary property owner contact 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 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 1 - /(�— Sign Bmrr] Signature ofBuver2/Spouse uis C.? eoch ((- 1513 Number License/ID/Other Number