HomeMy WebLinkAboutHomestead_Nossett INDIANA SALES DISCLOSURE FORM SDF ID: 2013 Page 2
D. PREPARER
•
Sara Adkisson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title •
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 Sara @swinland.com
City.State,and ZIP Code Telephone Number E-mail
E. SELLER(S)I GRANTOR(S)
Ronald A. Grubb Patricia A. Grubb
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2272 E. Presley Dr. 2272 E. Presley Dr.
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
d complete as required by law, and is prepared in accordance with "Real Property Sales Disclosure Act".
rid 0 41lAL b 1c r Qd Pay 0 butts-u- .77,413- & A ' r l 'a �a-
ignature of Se er t Signature of Seller' L
Ronald A. Grubb 19/2013 Patricia A. Grubb 7/19/2013
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
'"F. B r - •NTEE(S)-APPLICATION FOR PROPERTY TAEBUCTIOIQ3�FDF`TIFY ALL ITEMS THAT APPLY
/
/ Brian D. Nossett Cathy A. Nossett
_ Buyer 1-Nan- r..pears on conveyance document Buyer 2-Name ears on conveyance document
126 1st Ave. 126 1st Ave.
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660 Oakland City, IN 47660
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS •• • - •• . . IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
kl ❑ 1. Will this property be the buyers primary t 3. Homestead
,` residence? Provide complete address of primary • oar nergy Heatin 11�� st�i ,
residence, including county: 9y Flgt R•i
❑ 8 5. Wind Power Device 111 J�LJ1�LLJ
2272 East Presley Lane
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
IHaubstadt, IN 47639 Gibson ❑ 0 7. Geothermal Energy HeattGieo2liaitlice
,,,��t,,,City,State ZIP Code County ❑ a 8. Is this property a residential rental property:. .
yf' ❑ 2. Does the buyer have a homestead in Indiana to be ❑ a 9. Would you like to receiv-�; I, ; 41.,11,; for this
'` vacated for this residence? If yes, provide complete property via-email?(:' ri •8 s' jt .QJ M'dk
address of residence being vacated, including county: below. Please se Instructions or more to on'natton.
(61, 4 ). - I S (5614-941 Not available in all counties.)
Address(Number and Street)
OALIAd u111 NiWAo G• ,3 nz -0'3/o•dw-cox 3o- oaV
City. State ZIP Geode County Primary property owner contact name E-mail