HomeMy WebLinkAboutHomestead_Dewig (4) •
INDIANA SALES DISCLOSURE FORM SDF ID: 2013 Page 2
D. PREPARER
Kathy Masterson Escrow Officer
rof the Sales Disclosure Form Title
"05 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
•
Address(Number and Street) Company •
,;Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)I GRANTOR(S)
)•Donald-R:Dewi9.
L S Name as appears on veyance iocumen7 Seller 2-Name as appears on conveyance document
,Jc�a rand /�. --"tab-1
€ ddress:(NUmber and Street) Address(Number and Street)
•
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".
SignaNr eof Seller Signature of Seller
Donald R Dewig
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUY : GRANTEE(S)-APPLICATION FOR PROPERTY TAX • P - _ • •ENTIFY ALL ITEMS THAT APPLY
( Michael C. Dewi. l Erin J. Dewig
a e as appears on conveyance document ` • - - appears on conveyance document
9925 Winyard Place 9925 Winyard Place
Address(Number and Street)
�
Address(Number and Street)
vensville, IN 47665 Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR T •:•• : • IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION •• • •• ,
0 ❑ 1. Will this property be the buyers primary 0 ❑ 3. Homestead
residence? Provide complete address of prima • u 0 4. Solar Energy Heating/Cooling System
residence, including county:
9925 Winyard Place ❑ 0 5. Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
'Owensv--- ille, IN 47665 I —.
❑
Gib 0 7. Geothermal Energy Heating/Cooling Device
,
City, Slat ZIP Code County ❑ 0 8. Is this property a residential rental property?
0 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
{�,�7 / 09,ado - ooh 05/ _ oat
City, State ZIP Code County n�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, So ial Car,' 'ty and Driver's License/Other numbers are not necessa no Homestead Deduction is being filed.)
� �r� �/�
'nature of B er en ,,/ Signature uyer pouse
. �chael C. Dewig 0(7,94-4,0 3 Erin J. Dewig Oild-L//?G/ 3