HomeMy WebLinkAboutHomestead_Hommrich :INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - ' .- .
Chris Ferguson -_, Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main St. 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
E.SELLERS)/GRANTOR(S) - - •
Shawn Michelle Walker
Seller I-Name as wears on conveyance document Seller 2-Name as appears on conveyance document
12-66 E ecohia i?d
Address(Number and Screen Address(Number and Street)
o1 oonv i lie 1 I•1 LI-76o I
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
A iplete equired b a d is ep ed in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
re of el Signature of Seller
Shawn Michelle Walker 08/26/2013
Printed Name of Seller Sign Date(MM/DO/YYYY) I Printed Name of Seller Sign Date(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS‘•IDENTIFYALLITEMS THAT APPLY • .
rick J. Hommrich -.
rs on conveyance document Buyer 2-Name as appears on conveyance document
806 S.Lincoln St.
Address(Number and Street) Address(Number and Street)
Ft. Branch,IN 47648
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 ION
0 ❑ 1.Will this property be the buyer's primary NI ❑ 3.Homestea
residence? Provide complete address of primary 4.Solar Energy H C t
residence,including county: ❑ 0 5.Wind Power olin D ice
N I
117 S. Damosa Dr.
Address(Number and Street) ❑ 4 6.Hydroelectric Power Device t??
Ft. Branch,IN 47648 ❑ GI 7.Geothermal EnergyS&Rting IHlg Device
Ci ,State ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be
❑ 0 8.Is this property a residential rental pro erty?
vacated for this residence? If yes,provide ❑ TA 9.Would you like to ments for this
complete address of residence being vacated, property vi - Qndtilrj/ lotion
Ob 5inclp ng un below.Please see instructions for more information.
(�� ��4/7 Not available in all counties.)
( ,�����N fn„, y Y f 6_05 9✓ '24 -/P• 3(0- y03 -000.3 y9 p
City,State ZIP Code County
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 Securi d Driver's License/Other numbers are not necessary if no Homestead Deduction is
bei fi �. n� 'Q __- -.
Signature a erl /�(y Signature of Buyer2/Spouse
Number License/ID/Other Number