HomeMy WebLinkAboutHomestead_Ziliak (9) INDIANA SALES DISCLOSURE FORM SDF ID: 2014 • Page 2
D. PREPARER \ ,
Kathy Masterson Escrow Officer \I
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
E. SELLER(S)/GRANTOR(S)
Brandon Wright Natalie Wright
Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
805 W Gibson St 805 W Gibson St
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 i prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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Signature of Seller __� - _. Signature of Seller
Brandon Wright 77777����� Natalie Wright
Printed Name of Seller Sign Date(MMJDD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
Frs Y r. SJIGRANTEE(S);'A_PPLICATION FOR PROPERTY TAX DEDUCTION_S-IDENTIFY ALL T AT P L
/
le M. Ziliak � arch L. Ziliak I
Buyer ..-me as appears on conveyance document Buyer 2-N as appears on conveyanACp dgcug1 nt�A
5323 E. 1150 S 5323 E. 1150 S �MMtt 1 t� U Y
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639 1 , �i.mn
_
1 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION Y-- NO CONDITION
❑ 1i. Will this property be the buyer's primary ❑ ❑ 1 Homestead
residence? Provide complete address of primary . m 4. Solar :• eating/Cooling System
residence, including county:
805 W Gibson Street ❑ El 5. Wind Power Device
Address(Number and Street) ❑ El 6. Hydroelectric Power Device
'Haubstadt, IN 47639 Gibson' ❑ I 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ ( 2. Does the buyer have a homestead in Indiana to be ❑ El 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
5323E 1150S
Not available in all counties.)
Address(Number and Street) 8-319- ^� py� 4
Haubstadt IN 47639 co—1 Woo -coo. /V? w I
I City. State ZIP Code County Primary property owner contact name E-mail
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