HomeMy WebLinkAboutHomestead_Adams (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2,
fD.PREPART•-- --'—:`---7-7-7 _--- -TT., —7 - -_—_---.7F-777— ----
Laura Rininger Closing Coordinator I
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 E-mail
E.'-SEili R(S)yGRANTOR(S)--- "-- ---- - . � _ . -_,--- - - - ---
Nicholas Meny
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
102 S Campbell Blvd I
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639
Telephone Number Email
Under penalties of perjury,I h reby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an OmplQte as required b aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act",
Signature of Seller Signature of Seller
Nicholas Meny 4/19/2013
Printed Name of Seller Sign Date(MM/DD/YYIY) Printed Name of Seller I Sign Date(MM/DDMYYI
(Fe t . .. 'NTEE(S) ,APP,LICATION FOR P,ROP,ERTYTAXJ DEDUCTIONS=_IDENTIFY(ALOEFEMSiT clir P,iY - _
Karen S.Adams
riser -,...• • •ppears on conveyance document Buyer l-Name as appears on conv,yonce document
Karen
Ave.Apt 3 I
Address(Number and Street) Address(Number and Street)
Ft.Branch, IN 47648
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 CONDITIO, I
Fl ❑ 1.Will this property be the buyer's primary : 0 3.Homestead I / ,�
residence? Provide complete address of primary 4.Solar Ener gy a i of s''
residence,including county: I
❑ NI
103 S Haven Dr 5.Wind Power Device
Address(Number and Street) ❑ NI 6.Hydroelectric PiN0% Ve202013
Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County 1
El Fl 2. Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property. I ident 1 lit.- .perry?
1T7►.I r.
vacated for this residence? If yes,provide ❑ 0 9.Would y��b. �c :+4 ' � emen[s for this
complete address of residence being vacated, property via e-mail?(Pro .-ccmtriffPP)$rmation
including county: below. Please seeiinstructions for more information.
Not available all Counties.)
Address(Number and Street) I
016 i-16— o�i1cro ��3- Cb9
City,State ZIP Code County
Primary property owner contact name I Email