HomeMy WebLinkAboutHomestead_Halbig INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
ORREPATET>>: i-- ' -2- z_ .,- ��z a ty e -'*"-?:. ,r1�,.. ." '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
Ciry,State,and ZIP Code Telephone Number
E-mail
1E`.SELLER[SVGRANTOR[S)L xsx 2 a : > 7E— s
Amy R (O'Halloran)Igleheart
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
1466 S 100 E
Address(Number and Street) Address(Number and Street)
Princeton IN 47670 -
Telephone Number E-mail
Under penalties of perjury, 1 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 repared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
r
Signature of Sell Signature of Seller
Amy R Igleheart ( L .79i
Printed ' Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/OD/1TM
�Ffif3GYER[S)%GIANTE s)_APPLICATIONtF,OR'P.ROPERTYTAXt DEDUCTIONSMIDENTIFY'ALL"ITEMStTHAT.APPLY r - _ -=
( Lee M.Halbig
'tom Bu}'erI-Nam_ on conveyance document Buyer 1-Name as appears on conveyance document
`507 W.SR 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITION
Q 1D 0
1.Will this property be the buyer's primary ❑ 3.Homestead residence? Provide complete address of primary MI 12 . . , -nergy Heatir /CuLED
stem
residence,including county:
668 E 1075 S ❑ 0 5.Wind Power Device JUL 32013
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson El City,State ZIP Code County 0 7.Geothermal Energy Hea ' :/Coo -• • ;; • e
❑ 1A 8.Is this property a resid=4' 111.r: r�tu
❑ Q 2.Does the buyer have a homestead in Indiana to be N LuI •bro OR
vacated for this residence?_If yes,provide ❑ 1A 9.Would you like t rc RP-taaxOstatements 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)
—/9-.ea—A9/Ciao. 2/4—oaV
City,State ZIP Code County
Primary property owner contact name E-mall
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.
attire of Buyer r Signature ofBuyerl/Spouse
Lee M Halbig U. - 6- 13
Number License/ID/Other Number