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HomeMy WebLinkAboutHomestead_Michel (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -: . Lai ' ...C- .. _ H . y . Sonja Williams Banking Center Manager/Loan Officer Preparer of the Sales Disclosure Form Title 55 Main Street Elberfeld State Bank Address(Number and Street) Company Elberfeld. IN 47613 812-983-2541 svilliams eesbanc-com lity,State and ZIP Code Telephone Number E-mail re;SELLER(S)%GRANTOR(SJ. ' -- .__ I-____ - _IL -- 1.1 Fric M Rexing Clara B Rexing Seller I-Name as appears on conveyance document Seller 2-Name at appears on conveyance document 3 7 ass E 0. ti2`" 373 ? E SR. (DS- Aggress(Number and Street) Address(Number and [reef) �,s�acj i-I 14) Li 710 3 c( t-b�ibsf-ads, .TA/ q 7 & 37 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 require-- d bby��law,and is prepared in accordance with •6-1.1-5.5,"Real Prope .les Disclosure Act". Signature of Seller Signr•e of Seller Fric M Rexing 05/10/2013 Clara B Rexing 'di I I Printed Name of Seller Sign Date(MM/DD/Yrri( Printed Name of Seller Sian.,.,. (MM/DD. '-.,:U,YER(S)/GRANTE - 'PPLICATIONTOR PROPERTY TAX.DEDU.CTIONS_IDENTIFY ALLJTEMS)THAT APPLY___.°___ ____) Nicholas W. Michel Buyer I-Name as appears on cony- . ce document Buyer 2-Name as appears on conveyance document 9817 . - •-•^•r Drive • ' • s Number and Street) Address(Number and Street) Haubstadt, IN 47639 Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO' "OPERTY. IDENTIFY ALL OF TI • T APPLY. YES NO CONDITION I YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary Z ❑ 3. Homestead residence? Provide complete address of p '• : • 15 4.Solar Enerta - . g/Cooling System residence,including county: a - . 2801 W Soybean Lane . I'•• Power Device Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ © 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) // o?6 'let // kg ` I2 9—QC '�(n—Cb1 V 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 being filed.) - 71), e litA V. TI/I i Signature of Buyer] , of Buyer2/Spouse i;ckoigs 1- It ,ckek oc-Io- 13 Number License/ID/Other Number