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HomeMy WebLinkAboutHomestead_Koberstein (12) :DIANA SALES DISCLOSURE FORM SDF ID SDO ID 1388887 Paget D.PREPARER Samantha Cutsinger Preparer oldie Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 broadwaytitle1 @insightbb.com Q.ryt Stare,and ZIP Code Telephone Number Email E.SELLER(S)/GRANTOR(S) Jean G Riedford by Mary H.Koester,POA Michael R Riedford Seller 1-Name us appears on conveyance document Seller 2'Name as appears on conveyance document 819 S.Race St. 2950 E Top Hat Rd Address(Number and Sweet) Address(Number and Sweet) Princeton,IN 47670- Princeton,IN 47670- Gry,StnteandZlPCode City,State,.nn43B:C Jer . .tom it � 4) 1/4 • _._ �.�u ..a.I * .4/4 Telephone number Email 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 r quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property ales Disclosure Act". Si sure afSell Signature of Seller i A I eQ19 Cn>g) Pdi ONCei 1 -3-1 Z_ N1;eJ,Ar/ IZ t tedlic�?,/ /) `6 --i..� Pr■"■rA Nnmo ever Finn Ono-r BY'""lbw` Pr:ntM Nnrnenr Spar " r'auwrrv,nvvo, F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY Alva R Koberstein Kody R Koberstein Buyer 1-Name as appears an conveyance document Buyer?-Name as appears on conveyance document 727 W Evans St. 727 W.Evans St. Address(Number and Street) Address(Number and Street) Princeton, IN 47670- Princeton,IN 47670- City.State,and ZiPCode City.State,„and Z4 Code. �Y ,._ - 812- WA N/A Telephone Number Email Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION 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: ❑ 819 S.RACE ST. 5.Wind Power Device Address(Number and Street) ❑ © 6.Hydroelectric Power Device Princeton,IN 47670 GIBBON ❑ © 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. Not available in all counties.) Address(Number and Street) 26-1a — V $ -Zo 1 - 002 .qya -oag Ciry,Store ZIP Cade County Primary property owner contort name 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 required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.) F ,. in Signature of Haven Signature of Q71ver2rSpouse 1l"1-un R }-1t, 1E1P-(SA: e ,m, ,I 4 / i t Kid-( !Z Kat'rjf?n 1a ! (i%- PrintetlLeaalNOmeo-fir r 1 Sign Dose(NM/DD/YY'II Printed Legal Name of Sign Date(MM/DD;Tf}ft ,�,"�.” IN f _ IN Lastsdigits of Buyer l Driver's State Last 3 Digits ufsocial Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security License/ID/Other Number Number License/ID/Ocher Number i-