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HomeMy WebLinkAboutHomestead_Seaton INDIANA SALES DISCLOSURE FORM SDF ID: - Page 2 li.PREPARER _ - - - --� - - c 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 Ciry,State,and ZIP Code Telephone Number E-mail ,E:SEI:LER(S)%GRANTOR(S1- --__ . — Philip Andrew Paul Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 707 F Walnut St Address(Number and Street) Address(Number and Street) Ft Branch IN 47648 CEO,.State,and ZIP Code Telephone Number Under t -nalties of perjury,t hereby 'fy that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an• corn•%li to s re red by law, d is p epa din accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". f`1 a Signature of Seller Signature of Seifert Philin Andrew Paul 6/14/2013 Sian Date(MMmo/Ym� Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller %F:BUYER(S)/GRANTEE(Sin APPLIGATIDNJEORPROPERTYTAMEDUGTIONS7IDENTIFXALLITEMSTHATAPPLY T___ - __ - _ .. _ - Amber R. Seaton Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1617 E. Illinois Address(Number and Street) Address(Number and Street) Evansville,IN 47711 City.State,and ZIP Code Telephone Number THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead � gggg''1111 residence? Provide complete address of primary ❑ 12 4.Solar Energytl@gg/ oolis ti©'I residence,including county: ❑ 0 S.Wind Power vicl- 707 F Walnut St ❑ 5 6.Hydroelectric PDevic Address(Number and Street) Power 111 IA,11 qq�t1111 Ft. Branch, IN 47648 Gibson 7.Geothermal Energ)klh'Dtki /LTdDli tg Device City,State ZIP Code County ❑ - ❑ ❑ ❑ 5 8.Is this property a re idential rent.l pro e-rty? 2.Does the buyer have a homestead in Indiana to be ❑ O 9.Would you like to •�;,;.:.• yra a eats for this vacated for this residence? If yes,provide complete address of residence being vacated, property vitt; •-1' (e(gU:. ,IAvADIItI@<dlation below.Please see instructions for more information. including county: Not available in all counties.) ��'/1 /- Address(Number and Street) d f - 19-1 ]r go 11 O(ol9 N.1 aa(/J City,State ZIP Code County Primary(Oowner contact name E-mail property Under penalties of perjury,t 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 b>;iJlgfi ed.)Ra /�SiggnnaaattureofBuyer! �F(IC^ Signature ofBuyer2/Spouse - Amber R Seaton 6/14/2013 Number License/ID/Other Number