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HomeMy WebLinkAboutHomestead_Frederick INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Cesar Berrios Closing Services Preparer of the Sales Disclosure Form Title 7820 Eagle Crest Blvd,Ste 201 Regional Title Services Address(Number and Street) Company Evansville,IN 47715 812-759-5555 Ciry,State and ZIP Code Telephone Number E-mail E.SECL'ER(S)'/,GRANTOR(S)�_ 't _( Mary I Stunkel Seller 1-Name as appears on conveyance document Seller 2-Name as appears on convey-ance document 107 N Eileen St Address(Number and Street) Address(Number and Street) Haiihctadt IN 47639 Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct a d complete as uired law,and prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signet ea Sell. Signature of Seller Mary L Stunkpl 01/15/2014 Printed Name of Seller Sian Date(01.4/DO/YYYYI Printed Name of Seller Sian Date(MM/DD/YYYYI criBUYER(SVGRANTEE(S)`,=APPLICATION,FOR`P.ROPERTYLTAXiDEDUCTIONS-`IDENTIFYcALLITEMS:THAT:APPLY n Jill M. Frederick Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 306 Crestview Dr Address(Number and Street) Address(Number and Street) Owensville, IN 47665 PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION /� NO CONDITION 0 ❑ 1.Will this property he the buyer's primary ` u ❑ 3. Homestead residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System residence,including county: ❑ 107 N Eileen St 5.Wind Power Device Address(Number and Street) ❑ N 6.Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device Ciry,State ZIP Code County Fl ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ N 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below. Please see instructions for more information. 306 Crestview Dr Not available in all counties.) Address(Number and Street) Owensville, IN 47665 Gibson 8 36_40 a-000.3€a-ctQ Ciry,State ZIP Code County Primary property owner contact name E-mail