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HomeMy WebLinkAboutHomestead_Williamson (7) INDIANA SALES DISCLOSURE FORM SDF ID! Page 2 Laura Rininger Closing Coordinator Preparer of the Sales Disclosure Form Title 7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC Address(Number and Street) Company Evansville, IN 47715 812-759-5555 City,State.and ZIP Code Telephone Number I E-mail fi tLbtrt S 6RA\TOR ST. _ '----� -- - - _ -.' Cody 0 Frederick Taylor C Frederick Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 857 Hoing Rd E 857 Hoing Rd E I Address(Number and Street) Address(Number and Street) I Evansville IN 47725 Evansville IN 47725 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowleldge and belief,is true,correct and corn fete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". S(gnatur of Seller # *noun{of Seller Cody 0 Frederick 10/25/2013 • Taylor C Frederick I 10/25/2013 Printed Name ofSeller Sian Date(MM/DD/YYY1.1 Printed Name of Seller I Sian Dote OW/D0/1"1111 (F,BUYER(S)'/GRAN E(S)VAPPL`ICATIONF,OR.PR'OPERTXTAX-DED.UCTIONS-IDENTIFYiALf:'ITEMS:THATAPPLY(T , Kurtis D.Williamson I Buyerl-Name • ante document Buyer 2-Name as appears on conveyance document 717 Eisenhower Lane Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 Telephone Number I 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 - NO CONDITION I 0 ❑ 1.Will this property be the buyer's primary Fl ❑ 3.Homestea• residence? Provide complete address of primary a . . ar nergyHelting/Cooling System residence,including county: ❑ I g 5.Wind Power Devic YL j 1) 310E John St I Address(Number and Street) ❑ 5 6.Hydroelectric Pow e c Ft.Branch, IN 47648 Gibson ❑ 5 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ED 1511 2. Does the buyer have a homestead in Indiana to be ❑ 5 8.Is this property a resid�fi)il l�t107l perry? vacated for this residence? If yes,provide ❑ 5 9.Would you like io receive tax statements for this complete address of residence being vacated, property via e-mail?(P Waco toc lion below. Pleasesee instr n ormation. including county: � f Not available ircaidalttEsQUNTY AUDITOR Address(Number and Street) City,State ZIP Code County a619-x$-3° - 000 .e20)3-tat Primary property owner contact name I E-mail