HomeMy WebLinkAboutHomestead_Dillon (4) INDIANA SALES DISCLOSURE FORM SDF ID: 2013 Page 2
D. PREPARER
Kathy Masterson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 kathy @swinland.com
City, State.and ZIP Code Telephone Number E-mail
IIE�SELLER(S)./GRANTOR(S)
David S Hipp Mary J Hipp
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
12859 S Scottsdale Dr 12859 S Scottsdale Dr
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
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 required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
_S I/ qh, 1:G,-y
LSignature•of Seger / f 2 1.Signatare of eller �
David S Hipp I> >j_L _(:3 Mary J Hipp /3112----1-15 —__
Printed Name of Seller ( Sign,Date:(MM/DD/YYYY) Printed Name of Seller \_ Sign.Date.(MM/DD/Y.YY.Y) )
F,BUYER(S)/GRANTEE(S)--.APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Tony J Dillon > - Sara K Dillon
uye�"i - arttc s appears on conveyance document Buyer 2-�Name as appears on conveyance document
10183 S Quail Crossing l O( O-' Vii all C rOSS//2
Address(Number and Street) Address(Number and Street) /r-
Haubstadt, IN 47639 /gut DS%M27 )rQ W7C0 3°i
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES 0 CONDITION
- .2' ❑ (,1.e-Will this property be the buyer's primary ❑ (9 Homestea
residence? Provide complete address of primary
residence, including county: ❑ 4. eatin./Cooling S stem
12859 South Scottsdale Dr. ❑ 0 5. Wind Po .i iCE
Address(Number and Street) ❑ 6. Hydroele c `:
E
Haubstadt, IN 47639 Gibson' ❑ ❑ 7 Geothermal E.q�rgy �,/tjpgiCooling Device
City, State ZIP Code County 0 f21 8. Is this property a re dUUen'liall rental property?
❑c2./Does the buyer have a homestead in Indiana to be ❑ O 9. Would you IikeOjo recei e t s ents for this
vacated for this residence? If yes, provide complete property via- contact information
address of residence being vacated, including county: belovGlj c vg i ttct/pgmfrtrffre information.
10183 S QUAIL CROSSING Not available in all counties.
Address(Number and Street)
HAUBSTADT IN 47639 .Z‘ -22. -lyl_300 - 00 / , O1.2 -oa.Y
City, State ZIP Code County -1..- •roperty owner contact name -mail
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