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HomeMy WebLinkAboutHomestead_Chitwood • INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 .D:PREPARER- --r- 'Q°' - - 3`f =3...w =z,C�' x":1 _5?�%Z.ru�',�`Yrr �.`-:.��-•a ���:P•�y ,>�..•-.� �_� . Z .i:. 10; RITA PURDUE ESCROW CLOSER Preparer of the Sales Disclosure Form Title 9801 LEGLER ROAD NATIONS TITLE AGENCY Address(Number and Street) Company LENEXA KS 66219 8772564117 RPURDUEONATIONSLS.COM Clay,Soy re,and ZIP Code Telephone Number Email E.SELLER(S)/GRANTOR(S) L .. - . - 71'(°'_ • ADAM G CHITWOOD Seller I-Name as appears on conveyance document Seller 1-Name as appec.-s on conveyance document 518 SHORT ST Address(Number and Street) Address(Number and Street) OAKI AND CITY IN 47660 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 complete as r-quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". a'/7 ass-, 7 is •£ : �'-'5IGN:HERE,' Signature ofSeller '� �____..a.... ADAM G CHITWOOD 09/04(2013 Printed Name of Seller Sian Dote(NN/DD/17W) Printed Name of Seller Sian Dote 004/00/Y%Yl F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY:TAX(DEDUCTIONS=IDENTIFY AL'L ITEMS/THAT APPLY ADAM G CHITWOOD ALICIA CHITWOOD Buyer I-Name as appears on conveyance document Buyer 1,Name as appears on conveyance document 518 SHORT ST 518 SHORT ST 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 FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead ED residence? Provide complete address of primary ❑ © 4.Solar Energy Heating Cooling ystem residence,including county: - ❑ 0 S.Wind Power Device S/8 Al sYogT sT OCT 3 2013 A ere s .Lmbrr Street ❑ � 6.Hydroelectric Power Device o , A,�� c (T-, rAi 47L1.0 G:650 ❑ Q 7.Geothermal Energy Heatin ooling ev. Dos State ZIP Cade County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8.1s this property a residen vacated for this residence? If yes,provide ❑ 0 9.Would you like to czlaS0b6GOUNThistailligsOR complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all//c�ouu�nties.)/,(L rq,Jpt y/-�y�7 Address(Number end Street) — t4 B - 104-opt. ,JVUt-/� City,State ZIP Code County