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HomeMy WebLinkAboutHomestead_Angermeier • INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Jeannie M. Kiesel Title Administrator Preparer of the Sales Disclosure Form Title 221 N.W. Fifth Street Lockyear Title, LLC Address(Number and Street) Company Evansville, IN 47708 812-421-8405 City,State,and ZIP Code Telephone Number E-mail Patrirk J Gick and Krista A Gick husband and wife as tenants by the entireties Seller I-Name as wears on conveyance do rnent Seller 2-Name as appears on conveyance document 1 0412 5 2�i 0 VJ _Address(Numbecond Street) Address(Number and Street) 1-0(2---r 159—PciNta 4 , Ni 41 p4�6 Telephone Number E-mail Under pe 1 ies I p- jury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and u1 mpl a as q•ired by law,and is preared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act"- / �/ c-- e — 4% 12. ,yeti ‘V0orfr3 Signature ofS•l.� Signah e of Seller (� Patrick J.Gick DI-D6N"aDO Krista A Gick 0SIb?/oC3 Printed Name of Seller Sian Date(M.M/DO/rvrv) Printed Name of Seller Sian Date(.MM/OD/YYYn ,F.BUYEBTS)/GRANTEE(S)_APPLICATION,FOR-PROPERTY TAX DEDUCTIONS-IDENTIEYtALL ITEMS THAT APPLY —_ ___ • :_ Kassie Anoermeier Buyer I ameto appears on conveyance document Buyer 2-Name as appears on conveyance document • 214 N. Race Street Address(Number and Street) Address(Number and Street) Haubstadt,IN 47639 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_YFS d ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ Q S.Wind Power Device ILED 2t4 N. Race,Street Address(Number and Street) ❑ Q 6.Hydroelectric Power is Haubstadt, IN 47639 Gibson ❑ vi 7.Geothermal Energy Heati a ooling Device City,State ZIP.ode County ❑ Z 8.Is this property a residen rfae ❑ 2.Does the buyer have a homestead in Indiana to be rty? vacated for this residence? If yes, provide ❑ RI 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Prov cant t in/rl n including county: below.Please see instruc •ormation. N„t uv,.;lubl,,i,raZ& OUNTY AUDITOR Address(Number and Street) 24.- li. 3/ - 30/ - 000 , 07 Y "op City,State ZIPCode Coun Ttirmry property owner contact name -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 be ng filed.) / Signature of Buyer? }�c� t� I ��� Signature ofBUyer2/Spouse Number License/ID/Other Number