HomeMy WebLinkAboutHomestead_Sharp INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.'PP,REPARER.:c 3L_-a _->_ .,2_ _ -� `._ry f r.o-.,,_ -- -t* --. " - ;_t-_, ,
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail
:EiSELLsER(S)%GRANTOR(S). --- -._,_ .=' .7-7-- c:c77 __-7 -.2_„_ v-?' '-..,._ - _ .,ev.: 7772,
Kenneth R Munry Gary M Muncy
Seller!-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5407 N 650 E 902 Olive Dr
Address(Number and Street) Address(Number and Street)
Patoka IN 47666 Princeton IN 47670
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and cot .lete as re I i% by t ,and is prepared in accordance with IC 6-1.1-5.S,"Real Property Sales Disclosure Act".
Pita � A
Signature of Seller Signature of Seller
Kenneth R Muncy 5/15/2013 Gary M Muncy 5/15/2013
Printed Name of Seller Sign Date(NM/➢➢/YYYY) Printed Name of Seller Sign Date(MMIaD/vrrn
Ft BUYER(S)/,GRANTEE(S), APPLICATION;EORIPROP,ERT;YTTAX.DEDUCTIONS aDENTIF,YALLTITEMSTHAVAPP,LY-. s-. =._ _ors
Timothy A. Sham
Buyer!-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
404 S.Lincoln St.
Address(Number and Street) Address(Number and Street)
Ft.Branch, IN 47648
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 n 1.Will this property be the buyer's primary 12 ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heatingauo ystED
residence,including county: ❑ Agg Ig
113 N 3rd Ave 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson n 0 7.Geothermal Energy Heatitn?oSi(p2O4 ice
City,State ZIP Code County
❑ Fl 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 9.Would you like to receivefc stet or this
complete address of residence being vacated, property via e-mail?(Pro ma{�Q
including county: below.Please see il ,$r� s f� ��idt461.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code County
O - Q -I\-\a- io3-00Q.?II-Oo2R
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 fileet14--
Signature of Buyer! Signature of Buyer2/Spouse
TimothyA Sham 5/15/2013
Number License/ID/Other Number