HomeMy WebLinkAboutHomestead_Jorden INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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LANA C. HARPER CLOSER
Preparer of the Sales Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES,LLC
Address(Number and Street) Company
EVANSVILLE. IN 47708 812-468-8485
City,State,and ZIP Code Telephone Number E-mail
aE SELL'ER(S7GR:4NTOR( )'E . $.t'ti A: rt e Ta t" -;,rxta,_'ini:S lax",`sTR -A:02. ii.VS eAr
ROBERT.1 MCPFEKJR
Seller I-Name as ap Rears on conveyance document Seller 2-Name as appears on conveyance document
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Address(Number and SVeet), 11 Address(Number and Street)
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Telephone Number 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 f mpaete Is required byrl rid is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Si `/trlo—teller 4/0. . pit [pa'! �%i 3 Signature of Seller
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Printed Name of Seller Sign Date(MM/D0/YYYY) Printed Name ofSeller Sign Date(MM/PD/YYTY)
WPBUYER(S)'GRANTEE(S12,APP.L'ICATiomEOR"PROP,ERTYcAX:DEDUCTIONSfIDENfIEY;ALL°TTEMSiTHATYAPPLY�x
47427V7.JORDEN KATHRYN JM JORDEN
- ame as rs o convey& ce document Buyer 2-Name as appears on conveyance document
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Ad (Number andStreet) Ad (Number and Street)
rineeibn llll 1/7c970
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THE SALES DI LOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestea
residence? Provide complete address of primary a IA 4.Solar Energy Heating/Cooling System
r sid ce,i luding county:
❑ Q 5.Wind Power Device
(ogress(Numbe ndstreel) /,, /, /n, ❑ 0 6.Hydroelectric Power Device
r(ii�4Q k- I �7` 7O o f bson ❑ 0 7.Geothermal Energy Heating/Cooling Device
Ciry, a ZIP Code County
❑
ig
2.Does the buyer have a homestead in Indiana to be ❑ 8.1s 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 vacated, property via e-mail?(Provide contact information
including-county: below.Please see instructions for more information.
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Addrea(Number treet)
and
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City,State ZIPCode Cou
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 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.)
ACASignature of Buyer' f Signatureo Buyer2/S o
__MARK ;,U. J0 i'. Kam/ Jai ,7i)gAIJ 7111/3