HomeMy WebLinkAboutHomestead_Brown (5) • INDIANA SALES DISCLOSURE FORM SOF ID:_ Page 31
:15P.REPARER,-. _- _ - - -- . _ 1 ',.�.: v - '_.
Karen Harbison VP
Preparer of the Soles Disclosure Farm Title
803 E State Rd 68 Haubstadt State Bank
Address(Number and Street) Company
Haubstadt IN 47639 812-768-5800
City,State,and ZIPCade Telephone Number &mad
:ESELLER(S)'/,GRANTOR(S)1 _ --- - -- -
Frederick D Soencer II
Seller 1-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
1417 W Rabbit Run
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639
Telephone Number Email
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co ete as req by law,an ' prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
ignature of Seller Signature of Seller
Frederick D Spencer II 11/22/2013
Printed Name of Seller Sian Date(MH/OD/rrYn Printed Name of Seller Sian bate IAl Iuan i in
F'Rfrv� °_.-oPcS41.Q.RANTEE(SI 4PPLIGATIONIF,OR PROPERTIYLTA C4I .i■_• IONS ID t 'ALL:ITEMS THATrAPPCI �. , -,tiz„.z.,
Jarrod M Brown / Cheryl s Brown
Boyers-Name as an^ on conveyance document C Buyer 2-Name asappen- conveyance document
31 80 5 \\L 312T-780 S
Address(Number and Street) .. Number and.Street)
Ft Branch IN 47648 Ft Branch IN 47648
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary I 0 ❑ 3.Homestead : 4
residence? Provide complete address of primary tip r • , . ergy H Ei n�C ling tei ;
residence,including county: ❑ NI 5.Wind Power D ""ice
1417 W Rabbit Run
Address(Number and Street) ❑ 1 6.Hydroelectric Powayavvi es 2013
Haubstadt IN 47639 Gibson ❑ 0 7.Geothermal Energy�lYYHeeating/Cooling Device
City,State ZIP Code County
❑ 0 8.Is this property a re: eentialien . e • rty?
171 ❑ 2.Does the buyer have a homestead in Indiana to be 'WM*,
vacated for this residence? If yes,provide ❑ g 9.Would you like to r• '"' ents for this
complete address of residence being vacated, property viat'2I �ta ��n flhJS? anon
including county: below.Please see instructions far more information.
312E 780 S nNot available in all counties.) �,,�/(
Ft anch,IN 476448 Q/ /y Je 1M1-cox 99a. `"`tee V
Ft Branch,IN 47648 Gibson U00 (p vt..Ci-(�Cl
City,State ZIP Code County
Primary property owner concoct name E-mail