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HomeMy WebLinkAboutHomestead_Harris (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ,D.PREPARER - --- - - - - - Karen Harbison _ VP Preparer of the Sales Disclosure Form Title 803 E State Rd 68 Haubstadt State Bank Address(Number and Street) Company Haubstadt IN 47639 8127685800 kharbison(@esbanc.com City State,and ZIP Code Telephone Number E-mail SELLER(S12GRANTOR(S) - u - - -- _— Michael R Neufelder Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document A409 Kratzville Rd Address(Number and Street) Address(Number and Street) 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". Signature -� j1C ✓ Signature of Seller Michael R Neufelder 08/15/2013 Printed Name of Seller Sian Date IMM/OD/rYYn Printed Name of Seller Sian Date rMM/DD/rvftt BUYER(SWGRA NTEE(SJL.APPLICATIONFOR PROPERTY_TAXDEDUCTION5_IDENTIFYALLITEMSTHATAPPLY_ - __-- _ Jeremiah E Harris Kelly L Harris o"mr,-..w.•e s ',pears on conveyance document Buyer 2-Name as appears on conveyance document 505 E Gibson St 505 E Gibson St Address(Number and Street) Address(Number and Street) Haubstadt IN 47639 Haubstadt IN 47639 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 YES °° E0i:91 ❑ ❑ 1.Will this property be the buyer's primary < — — 3.Homestead g� residence? Provide complete address of primary «< ❑ © 4.Solar Energy Heating/Cgly em residence,including county: ❑ 1. 110 S Camvbell Blvd 5.4l Ind Power Device • Address(Number and Street) ❑ 111 6.Hydroelectric Power Device t1 Haubstadt IN 47639 Gibson ❑ ❑ 7.Geothermal Energy Heating/Cj Ig�leO�ti013 City,State ZIP Code County ❑ si 8.Is this property a residential rental property? ❑ 2.Does the buyer have a homestead in Indiana to be • vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to receive tax. ..Li complete address of residence being vacated, property via e-mail?(Prxv1�$'r/g s(r •fitMah4hPITOR including county: below Please seeinstrud?OWs or more information. 505 E Gibson St Not available in all counties.) Address(Number and Street) pp /4 .p Haubstadt,IN 47639 Z 4 � /6 - 3 ,((0.3 -a0O. 540 40, City.State ZIP Code County Primary property owner contact na,ne 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 b rig filed.) I P6A/1 •/ 3:gnamre of Buyers Signature o Buyer?/Sese I Jeremiah F Harris 08/15/2013 Kelly L orris (� 08/15/2013