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HomeMy WebLinkAboutHomestead_Vincent INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2 D. PREPARER I. Kathy Masterson Escrow Officer Preparer of the Sales Disclosure Form Title l 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 f,,,E. SELLER(S)/GRANTOR(S) ,I Regions Bank DBA Regions Mortgage Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 215 Forrest Street Address(Number and Street) Address(Number and Street) Hattiesburg MS 39401 • 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 complete as requi ed by I d is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". Signatd Seller !el �� Signature of Seller 54-0.44., �? 710-,--- �/ib/aof y r Printed Name of Seller Sign Date(MN✓OD/YYYY) Printed Name of Seller Sign Date(MM'DD/YYYY) F7BBUYER(S)/GRANTEE(S)_APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY =a • Jeff Vincent Charity Vincent Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 425 North Mart Street 425 North Mart Street . Address(Number and Street) Address(Number and Street) Morganfield, KY 42437 - d Y L OF THOSE THAT APPLY. Y�E($ NO CONDITION YES NO CONDITION p-i , y ❑ /1. Will this property be the buyer's primary ❑ 3.3 HomestAead -�f.,af , / residence? Provide complete address of primary A14/ Solar Energy Heating/Cooling System residence, including county: �pp 11168 W 1000 S ❑ ,V 5. Wind PawegeRicl 2014 • Address(Number and Street) ❑ R"6. Hydroelectri Power Device Poseyville, IN 47633 I Gibsorj ❑ fi— 7. Ge�otherm: .f„ ...� II_ -.. ing Device ,) City,State ZIP Code County ❑ 12"8. Is Vtic rgeilgigirl�n,a.rental eroperty? ❑ / :2. Does the buyer have a homestead in Indiana to be ❑ .8"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. Not available in all counties.) Address(Number and Street) ^ (� City,State ZIP Code h��' _ 3a-'Oa_ t o4. 3'v-WI Primary rypropert owner contact name E-mail . ! Iii