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HomeMy WebLinkAboutHomestead_Bechtel _INDIANA SALES DISCLOSURE FORM SDI'ID: Page 2 ;D.-PREPARER,., n - _., s ',3.. = ._ c- -V- a.:.7 . . - ----- —�-i Karen Harbison VP I Preparer of the Sales Disclosure Fonn Title 803 E State Hwy 68 Haubstadt State Bank Address(Number and Street) Company Haubstadt IN 47639 812-768-5800 kharbison(Wesbanc.com City.Sta re,and ZIP Cade Telephone Number !me,d ;E.iSFLLER(S)JGRANTOR(S)z _:, e_�.±±.1_- -'_-L i_& -. , - James T Czoer I Seller I-Name as appears on conveyance document Seller 2'Nome as appears on con verunr,f document 650 F 10?5 S Address(Number and Street) Address(Number and Street) Haubstadt IN 47639 Telephone Number I Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct andn ompl teas re ired by law,and is prepared in accordance with aIC 6-1. 1.5 .5,"Real Proiierty Sales Disclosure Act". ,re ofileer 1 Ja sTC2oer 71177!2073 noted Name of eller Sian Date Imo/00 M nl Printed Name of Seller I Sup,Duct:;!.,4:it,:■I i ,F BUYER(S)/GRANTEE(S)' APPLIGATIONiiE ORPROPERTY7TODEDUGTIONSLIDENTIErf iGLlITE¢IS-THAT.APPLY'.'`-[ `I Michael C Bechtel Breanna J Bechtel Buyer!-Name us appears on conveyance document Buyer 2-Name as appears on con vpvme d,n'mnrnt 432 Bradley Dr 432 Bradley Dr _ Address(Number and Street) Address(Number and Street) 11 YES NO CONDITION I YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead residence? Provide com lete address of rimar Y ❑ © 4.Solar Energy eating FI oo ing ystem residence,including county: I 5.Wind Power Devi' 1350 W Chukar Hollow I b'E C 13 2013 Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Haubstadt IN 47639 ❑ 0 7.Geothermal Ener ieatin C evice City,State ZIP Code County I J!'�/T{}� ❑ F4 2.Does the buyer have a homestead in Indiana to be ❑ ❑ 8. Is this pl'opeISON COUNTY AUDITORt}? vacated for this residence? If yes, provide ❑ ❑ 9•Would you l t to I Ccelve tax statement'.for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below. Please se!,hist-ructions for more:r!;nrme;!..c Not available in1all counties.) Address(Number and Street) j� City,State ZIP Code County ...-3-36- Via. 699-a7Li_ Primary p,uper t y ownercontart name 1 , ,