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HomeMy WebLinkAboutHomestead_Clark (3) INDIANA SALES DISCLOSURE FORM SOF ID SDO ID 1791945 Page 2 D.PREPARER • Samantha Cutsinger Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. _ Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 Samantha.bti@mw.twcbc.com City,State,and ZIP Cade Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Jess F Bailey by Mark A.Bailey,attorney in fact Mabel L Bailey by Mark A.Bailey,attorney in fact Seller I-,Vame as appears on conveymce document Seller?.Name as appears on conveyance document 12021E 200 S 12021E 200 S Address(Number and Street) Address(Number and Street) Oakland City,IN 47660- Oakland City,IN 47660- 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 re'At' e//d by laws',and> per•p�•d in cordance with IC 6-1.1-5.5,"Real Proper ales Disclosure�c - r I ./ - • (� de I ., S-- J"o4 lit_ a./. - !- - - kid'' •14.-1...a. -!'• Signature of Seller ■-, Signature of Seller • Sass f Z4/t&Y 5-5-IV 1%43et. -4 - 34-fic_y 5-S-)y Pr•.,e,r N-•.prr4nr. tie-f,-•e rt•yrnP•WYR1 Prt..rl.rtnenfUM, C;�r lMrn r.,a,•,nmvn F.BUYFR1S1/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY Matthew C Clark Haire J Clark 1 Byer I-Name orappecn on conveyance document Buyer?-Name us appears on conveyance document 231 E.Columbia St. 231 E Columbia St. Address(Number and Street) Address(Number and Street) Oakland City.IN 47660- Oakland City,IN 47660- THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO 1.CONDITION this FILE © ❑ 1.Will this property be the buyer's primary © ❑ 3. Homestea. FILED residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System residence,including county: ❑ 12021 E 200 S 5.Wind Power Device MAY 0 8 2014 Address(Number and Street) ❑ ❑ 6. Hydroelectric Power Device Oakland City,IN 47660 GIBSON ❑ © 7.Geothermal Energy Heati Coolin De City,State ZIP Code County tkllL•4`et. © ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © 8. Is this property a residen �Ca tv? vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to receive a.statements or is complete address of residence being vacated, property via e-mail?(Provide contact information including county: below. Please see instructions for more information. 231 E COLUMBIA ST. Not avails e - in all counties. Address(Number and Street) Oakland City,IN 47660 NOT APPLICABLE a 6 - PI j. i 9 _ 400 -000. 0 0• oo o City.State ZIP Code County ___,„ ' may property owner contort name E-mail