HomeMy WebLinkAboutHomestead_Kohl INDIANA SALES DISCLOSURE FORM - SDF ID: Page 2
LD.a?REBAREV':. -. ,77- .- -- __ ----.--->--- - '-- -- -- O':
Laura Rininger Closing Coordinator
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
City,State,and ZIP Code Telephone Number E-mail
E?SECLER[ST%GRANTaf(SI; ---- - -_ _ , _ - -:.-_-.- .. -_ - _T -
David F Keller 1 inda C Keller
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
115 S Weber Dr 115 S Weber Dr
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•com ete as re uired by law,and is prepared in accordance with IC/6-1.1-5.5,"Real Property Sales Disclosure Act".
� � i� tL) eAtL&
Signature of Seller Signature of Seller
David F Keller 4/17/2014 Linda C.Keller 4/17/2014
Printed Name o(Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/D0/YYYY1
g,• • •NTEE(S);=_AP,P,LICATIONEF,OTPROP.ERTY,TaDEOUCTIONSL-1IDENTIFW°AIiL:ITEMSITHAT(APPCY'___ ___,____
Evan D. Kohl
is appears on conveyance document Buyer 2 Name as appears on conveyance document
Evan D.
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO 3.UomON i���
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homeste yr //p
residence? Provide complete address of primary ❑ 4.Solar Energy eating/Cooling System
residence,including county: ❑ Fl S.Wind Power 4 2014
115 S Weber Dr ���2
Address(Number and Street) ❑ ig 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ Fl 7.Geothermal E gy Hed-r ,,I •o ing Device
Ciry,State ZIP Code County _.,)�,• -il h
❑ IS 8.Is this grope • •j"'ti..�fperty?
❑ 0 2.Does the buyer have a homestead in Indiana to be RRSSGtO COU .
vacated for this residence? If yes,provide ❑ 0 9•Would9blace 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) 073- 009
a‘-i�- JG aOOa.
Ciry,State ZIP Code County
Primary property owner contact name E-mail