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HomeMy WebLinkAboutHomestead_McConnell (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 aPREPARER _.—_ _ - - _ _ - _ _ _ a Stacey Salzman Closer Preparer of the Sales Disclosure Form Title 4962 Lincoln Ave. First Advantage Title Address(Number and Street) Company Evansville, IN 47715 812-490-8485 theteam(D�firstadvantagetitle.com City,State,and ZIP Code Telephone Number E-mail E:.SELGER(S)%6RANTOR(S) . - .7 7_• Jonathon A Willis Ashley F Willis Seller l-Name as appears on conveyance document Sell r 2-Name as appears an nveyance document Address(Number and Street) ess( umber an veer) tak_I tai 0, 1 id 41&&0 1.1.061( at-t-t I1■J 14162111a Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co plete as required-by law,and is prepared in accordance t 1C 6-1.1-5 5,"R�e`al Property Sales Disclosure Act". UVf Signature of Seller Signalwea/Sel Jonathon A Willis 07/15/2013 Ashley E.Wil 07/15/2013 Printed Name of Seller Sian Date(MM/aD/WM Printed Name of Seller Sian Date(MM/UD/YYYY) _ - F.BUYER(S)/GRANTEE(S)=.'APPLICATION FOR PROPERT�Y:TAX�DEDUCTIONS-IIDENTIFY;ALL'JTEMSTHATAP.PLY_ '„- , _, Patrick R.McConnell Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 925 North Polk Drive Address(Number and Street) Address(Number and Street) - Oakland City, IN 47660 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR T IS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. . YES NO CONDITION YES NO CONDITION f3 Z ❑ 1.Will this property be the buyer's primary 71 ❑ 3.Homestead residence? Provide complete address of primary residence,including county: ❑ © 4.Solar Energy HeatirZ �oolin ys m 925 North Polk Drive) ❑ 6.Hyldroelectrlc�B�N Device OUNTY AUDITOR Address Number and Street) City, IN 47660 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device City,State IIP Code County ❑ 71 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 ❑ Z 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. Not available in all counties.) Address(Number and Street) n �1C�y1,.,�1 /,',�J -�(1 City,State ZIP Code County (210-( - " R-2o�-�o .11M Vo'J 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 I w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note: Spou a informatio/n,S Social curity and Driver's License/Other numbers are not necessary if no Homestead Deduction is b �7�7C % / ISignature of Buyer) Signature ofBgver2/Spouse Patrick R McConnell 07/15/2013 Number License/ID/Other Number