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HomeMy WebLinkAboutHomestead_Layman INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1788162 Page 2'., .D PREPA RER'' iL if.:.'2' ♦- -•'_ _rt. t.''.,3::'• ,• _•,._ :r ' __._ a _.. .'_: 17-7,-,71;s':`_ _.. Kimberly A.Lewis Office Manager Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 kim.bti@mw.twcbc.com City.State,and ZIP Cale Telephone Number E-mail zE.'SELIIER(S)/G RANTOR(S)&& .-`.-._. . .' . .L. tr h i t'. 4'c.::. 3 - -Itij — .._:'1.z - - Maleaha S.Eagleson Seller I-Nome as appears on conveyance document Seller Z-Name as appears on conveyance document 705 E.Ulen St. Address(Number and Street) Address(Number and Street) Ft.Branch,IN 47648- / 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 •omplete s require by I. and ' prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". �Q�1�L Q ,%ems Oure Seel�le�rt 1 ¢ ` 41 A / ' Signature of Seller nrer cc--nr• nnmmn Pr'n•MN"•- n/erne- 4"n nr,fin,tan maw • '. ry .' -•n o. rrvw r ...:U]'ER(S)/GRANT • S)=7APPLICA IIN,FOR'PROPERTY.TAX•DEDUCT - - •ALCITEMSTHAT'APPLY;.;> .::. r_:_'7:i.-. Christopher M.Layman Me- a A.Layman Buyer I•Name as appears a. onve)mre document -Name sa on conveyance document • •- 6154 W.Stalheim Ave. Address(Number and Street) Address(Number and Street) Owensville,IN 47665- Owensville, IN 47665- YES NO CONDITION NO CONDITI . © ❑ 1.Will this property be the buyer's primary El ❑ 3.Homestead FEB 13 2014 residence? Provide complete address of primary 4. gy Heating/Cooling System residence,including county: ❑ 705 E.ULEN ST. 5.Wind Power Device Address(.Number and Street) ❑ ❑ 6.Hydroelectric 2.Does the buyer have a homestead in Indiana to be Pa1inb,yiF,pUNTY At', :'J ❑ >`] Ft.Branch,IN 47648 GIBSON ❑ ❑ 7.Geothermal Energy Heating/Cooling Device Cu',',State ZIP Code County ❑ ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ © 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. Not available in all counties.) Address(Number and Street) /�A(/ n,.//�' �JJ /��/� //}/� City,State ZIP Code County a -/ /"" r `Oat [.(/fit/, /a/L.C/14, Primary property owner contact name E-mail