HomeMy WebLinkAboutHomestead_Leek INDIANA SALES DISCLOSURE FORM SDF ID: rage 2
D.PREPARER. - - -
Jamie Perry Closing Department
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd,Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville. IN 47715 812-759-5555 Jamie.perryeregionaltitlellc.com
Ciy,State,and ZIP Code Telephone Number E-mail
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E.SELLER(S)/GRANTOR(S)
Dacia S Kramer
Seller I-Nome as appears on conveyance document Seller 2'Name as appears on conveyance document
96626 W Winyard Place
Address(Number and Street) Address(Number and Street)
Owensville IN 47665
Telephone Number E-mail
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a omplet as r quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature ofSeller // Signature of Seller
1
Dania S Kramer t/4 -�' -;LI
Pri^, s•' Sian Date IM04/DD/YYY17 Printed Name of Seller Sian Date(H14/DO/%M
BUYERS)/GRANT (S) APPLICATION-FOR-PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
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••ceeL...h'e appears an conveyance document Buyer Z-Name as appears on tonveya I p1 ,, ED
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507 S Center Street
Address(Number and Street) Address(Number and Street)
Ft. Branch. IN 47648
Telephone Number • E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY 1 IFY ALL OF THOSE THA
YES NO CONDITION YES NO CONDITION BSON COUNTY AUDITOR
0 ❑ 1.Will this property be the buyer's primary 12 n 3.Homestead
residence? Provide complete address of primary n 4.Solar Ener• mg/Cooling System
residence,including county: ❑
9626 W Winyard Place 5.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Owensvilie, IN 47665 Gibson n S 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
❑ 0 2.Does the buyer 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) d6 -/! 'O ^a�- nod:. W/ /
Ciry,State ZIP Code County Y
Primary property owner contact name E-mail