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HomeMy WebLinkAboutHomestead_Jenkins (4) INDIANA SALES DISCLOSURE.FORAI SDI:ID SDO ID 1787657 Paget D.PREPARER Bryceann Nichole Cutsinger Preparer of the Sales Disclosure Form Tide 226 W Broadway St. Broadway Title.Inc. Address(Number and Slices) Company Princeton, IN 47670- _ 812-386-1687 samantha.bti @mw.twcbc.com City.State,and ZIP Code Telephone Number Email E.SELLER(S)/GRANTOR(S) Connie S.Karat( -,r,it Seller I-Name us amnos unhurt ryx,re document Seller 'Nume m appmn on ton coroner document 806 S Lincoln Address(Number and Street) Address(Number and Street) Ft.Branch,IN 47648- Telephone Number E-nail 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 's prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". a :c,‘5 M-t -zr rj-iignature of Seller Signeunre of Seller 0nnle.. S - _r mmr;elLi /-cM-/ Pr-red N.mo rrt.ro.- Cinn n..r PM',IVil Primed Vr.na nr5,11pr cfrn Orre Ortm gin+wn F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY Darrin L.Jenkins 5144 p.)9,Jenkins Buyer I-Name as appears an conveyance daeumen: Buyer Z-Nome us appears on conveyance document 109 W Savannah 109 W Savannah Address(Number and Street) Address(Number and Street) Jasper,IN 47546- Jasper,IN 47546- [ 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 NO CONDITION Q ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating Cooling S stem residence,including county: ❑ ID 806 S LINCOLN 5.Wind P w ryep_e ce Address(N'umberond Street) ❑ ❑ 6.Hydrae ctrl Ft.Branch,IN 47648 GIBSON ❑ © 7.Geothermal Energy HeatinE''/Cooling Device City.State ZIP Code County ^1 n q-t)(1�71 n ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © 8.Is this propP,}',A rLa71E15t�l rental property? L vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to receive t x star ments for this complete address of residence being vacated, property via ail? Mt e contact information including county: below.Plea t I 1T tT y ff(c'fm information. 109 W SAVANNAH Not SiBISc vrral)1t snhes: I Address IN 47546 and Street) WO 3g.5100,r Jasper,IN 47546 DUBOIS a�- L a_ i a - JD3' VVY-/ , --// City,State ZIP Code County l Primary property owner contact name E-mail