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HomeMy WebLinkAboutHomestead_Wright (2) . INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 :D:YREPARER � 4.,.,__�'-_ •. -..e:�-.. ,..-,; _ � �_ - :,: , . _ -. _ .-_•_. 117' - •,.: KAREN HARBISON VP Preparer of the Soles Disclosure Form Tide 803 E STATE HWY 68 HAUBSTADT STATE BANK Address(Number and Street) Company HAUBSTADT IN 47639 812-768-5800 kharbisonOesbanc.com City,State,and ZIP Code Telephone Number E-mail °E?SELIiER(S)fGRANT.OR(S) ____ • _ -_ TONY J DII I ON Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document 19859 S SCOTTSDATE PR Address(Number and Street) Address(Number and Street) HAUBSTADT 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 and comple -qui ed by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". mime (Seller Signature of Seller TONY J DILLON 03/24/2014 Pnnted Name of Seller Sian Date(MM/oo/Yeen Printed Name of Seller Sian Dare(MM/DO/YYin F:.13UY£R(S)/GRANTEE(S)'`APP.CIGATION;FO2W.ROPER•IVFAX,DEDUCTIONS=-IDENTIEY!ARE1TEI∎ THAT'APP,E —7 BRANDON S WRIGHT NATALIE M WRIGHT Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 805 W GIBSON 805 W GIBSON Address(Number and Street) Address(Number and Street) HAUBSTADT IN 47639 HAUBSTADT IN 47639 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ i I 10183 S QUAIL XING S.N nd Power Device Address(Number and Street) ❑ IZ 6.Hydroelectric Power Device HAUBSTADT IN 47639 GIBSON ❑ El 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 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. 805 W GIBSON Not available in all counties.) Address(Number and Street) ^� HAUBSTADT IN 47639 GIBSON i)(9-18 '310-30o ' Ooa• pal - o&11 City.Stare ZIP Code Comm, Primary property owner contact name E-mail