HomeMy WebLinkAboutHomestead_Westheiderman INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - _ -_ _ . . .. _ _ - - . __ .
Jamie Perry Closing Department
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd.Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 __ 812-759-5555 iamie.perrv(o�regionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLERJS)/GRANTOR(S) . - - _. .. . . _ _
Darrell Hodson Katrina Dodson
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
11 W Red Rank Rd 11 W Red Bank Rd
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and plete as r fired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
S unaatre Seller Signature of Seller /f f'7 ;�,;)
Darrell Dodson N 7 /� Katrina Dodson 4" /'L�)I4-
Printed Name ofSeller Sian Date(MM/DO/Yin) Printed Name of Seller Sian Date(MM/DO/WrY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX-DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY_.. - _
Megan Renee Westheiderman
B•ver1-Name as appea on conveyaned enr Buyer 2-Name as appears on conveyan d u. n[
K. ex - �L
A (yN�+umber and StrtQ Address(Number and Street)
�Ctloll / J L v APR 142014
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THO$]: �( OUNTY AUDITOR
YES NO CONDITION I YES NO CONDITION l7�
❑ 1=Wi1P.this.propertybe.the;buyer s:primary- ❑ 3r 1-lomestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
?esicl nce ncluding coup ❑ GI S.Wind Power Device
I 1 IiI J tie {� .
ddre�s(Numb.and I—7 , /k I ❑ 0 6.Hydroelectric Power Device
1—;�r —r 1 \f ccnrll T N1 �f /LP`t'J C k\0'1 ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State-Z�/lP County
❑ L>d 2.Does the'buyr have:a:homestead.in:Indiana to be ❑ 0 B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 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)
Z1P—IS - Zy - ZOZ, - ono 112-7-0Q6
City,State ZIP Code County
Primary property owner contact name E-mail