HomeMy WebLinkAboutHomestead_Templeton INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Jamie Perry Closer
Preparerof the Sales Disclosure Form Title
7820 Eagle Crest Blvd,Ste 201 Regional Title Services, LLC
•Address(Number and Street) Company
P ny
Evansville, IN 47715 812-759-5555 iamie.cemeregionaltidellc.com
City,Smtc and ZIP Code Telephone Number
E-mail
ESELLER(S)/GRANTOR(S1 :., „ 1 - '
Michael R Helmer Karon S Helmer I
Seller l-Name as appegrz conveyance document Seiler 2-Name as 141-pn appparj on conveyance document
12400 Hvpr 19N et 1117 12400 Hwy 19N Kett 1117
Address(Number and Street) Address(Number and Street)
Clearwater Fl 39764 Clearwater FL 33764
Telephone Number I 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 re uired by law,and is/prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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n *Seiler �r 7° Signature. oHelm O I` �\,1
Michael RHelmer /V '0` -/3 Karen S Helmer I I laJ∎ ?).
Printed Nome of Seller Son Date(NN/DD/YTIY) Printed Name o(Seler I Sian Date(IIN/DD/Yn )
F.:BUYER(S)/GRANT£E(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY_ALLITEMSTHATAPPLY .: .
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Buyer I-Nome as appears on conveyance document Buyer 2-Name as appears an conveyance document
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Add `(Number and Stmt) Address(Number and Street)
tNXYS11t [lP
Telephone Number I E-mail
filE 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
Q I] 1.Will this property be the buyer's primary 0 ❑ 3.Homeste I 1 ,
residence? Provide complete address of primary ❑ Fl 4.Solar Ener ti Cot
sidence including county: �••� '
L --I 5. IV') ❑ Fl 5.Wind Po Device
Address r\nmC Q\tn Street) `A, 0 H��111 / 1hSO Y\ ❑ PA 7.Geoth:Hydroelectric Energy qr�eg/13'� l ,` Hid() IVnt if) ❑ 7.Geothermal Ene Heating/Cooling Device
�Gty,Smte ZIP Code Coun -
l`J ❑ 2.Does the buyer have a homestead in Indiana to be ❑ S.Is this property. r ide �e,_, .r property? -
❑ 0 9.Would you like: •Cr. �"i".+D.-• ,;,. for this
vacated for this residence. If yes,provide y '�'� �C.
complete address of residence being vacated, property'vw - -in roviee con 'Ctinformation
/ �' -n coupty: jj below.Please see instructions for more information.
�!q .n (���( Not available in all counties.) .
c u M°I' � �€. xJ .1477/I i o u . )a aq - to -.e s -- aa7
des State ZVP Code County
Primary property owner contact name I E-mail