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HomeMy WebLinkAboutHomestead_Harper (4) INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1778882 Page 2 D.PREPARER Cassie Williamson Preparer of the Sales Disclosure Form Title 226 West Broadway Broadway Title Inc. Address(Number and Street) Company Princeton,IN 47670- _ 812-386-1687 kin-bti©insightbb.com City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Jack L Simmons Seller 1-A'ume us appears on commune document Seller Z-Plume us nppean on conveyance document 1766 Dunvegan Drive Address(Number and Street) Address(Number and Street) Port Charlotte,FL 33980- 0�/�,//TCiy/, Telephone Number E-mail Und- penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belie(,is true,correct and�i •lete as required law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Si• re of Seller r�•• .Signature of Seller -lade L. U/MMDn/S /2 J-'/ / 3 _ _ Famed Mrrm"ne CAR, Ch,Mra'mu•nnm»i Prinmd,Yn,nonrcrllor mm •F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE sr T -i• '•P. it nn Christian I Harper Buyer appears on conveyance document Buyer 1-Name as appears on conveyance docu 322 South Gibson Jf�� 222013 Address(Number and Street) Address(Number and Street) Oakland City,IN 47660- n/ etr Telephone Number _ _ E-mail_ THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YE/ Nf rr]NDITIDN © ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of prima ❑ ❑ 4.Solar Energy Heating/Cooling System residence,including county: 831 NORTH MAIN STREET ❑ © 5.Wind Power Device Address(Number and Street) . El 6.Hydroelectric Power Device Oakland City,IN 47660 NOT APPLICABLE ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ El 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. lot available in all counties. Address(Number and Street) a4 - /Y-/y- 7o/ -coo. . 55-oo 7 City,State ZIP Code Co my Pn moa 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 infor • Ion,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is bein; . e er.. d�—�)B'- ,-i Signature ofBuyerl/Spouse Number License/ID/Other Number