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HomeMy WebLinkAboutHomestead_Lienemann (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D PREPARER Sherri S Hudson Closing Manager Preparer of the Sales Disclosure Form Tide 501 Main Street Suite 101 Bosse Title Company Address(Number and Street) Company Evansville, IN 47708 812-421-4000 City,State,and ZIP Code Telephone Number E-mail Sean D Lienemann Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2342 S Old State Rd 65 Address(Number and Street) Address(Number and Street) Owensville IN 47665 - 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 prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature 44SeUer— Signature of Seller Sean D I ienernann 7- 31-/3 Printed Name of Seller Sian Date(NM/OD/YYYY) Printed Name of Seller Sian Date(MM/DO/MY) .F;BUYER( to ES)`APPLICATIONFORPROPERTYTAXDEDUCTIONS=,IDENTIFYALL'ITEM11S-THATAPPLYL- _ _ _ it Zachary D.Lienemann Buyer 2-Name as appears on conveyance document 1144 S Old State Rd 65 Address(Number and Street) Address(Number and Street) Princeton, IN 47670 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 I Y NO rUND ION -in ❑ 1.Will this property be the buyer's primary j i ❑ 3.Homestea residence? Provide complete address of primary ' "R U 4.Solar Energy Heating/Cooling System residence,including county: ❑ 5.Wind Power Device 2342 S Old State Rd 65 Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Owensville, IN 47665 Gibson 7.Geothermal Energy Heating/Cooling Device Ciry,State ZIP Code County ❑ 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 ❑ 0 9.Would you like to receive tax statements for this complete address of residence being faceted, - --property viae=mail?(Provide contact information-- including county: below • -e • •• :e . ctions for more information. Address(Number and Street) a4 •// -/9- 4400 - 000. 23s-v.) / Ciry,State ZIP Code I,un • 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,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.) 07-3/-11 Signature ofBuyer2/Spause 7arhary D I ienpmann Number License/ID/Other Number 3C - " I 3-On Sth M