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HomeMy WebLinkAboutHomestead_Bruce INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 CHRISTINA LATHAM TITLE CLERK Preparer of the Sales Disclosure Form Title 4703 THEATER DRIVE REGIONAL LAND TITLE Address(Number and Street) Company EVANSVILLE, IN 47715 812-402-4553 CHRISTINA(a�REGIONAL-LT-COM City,State,and ZIP Code Telephone Number E-mail _E SELLER(S)/GRANTOR(S). — -- - —. _ — --- - �.--.h__ ----- Tom W Masnn Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 9397 E 125 S Address(Number and Street) Address(Number and Street) OAKI AND CITY IN 47660 Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct nd complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ignatar of Seller Signature of Seller /// Tom W Mason V 75' ���Priinnttee-d�Npapme of Seller Sion Date(MN/DD/YYYYI Printed Name of Seller Sian Date(M.M/DD/YYYY) fatrtE 'S _ _ l . ___ -- _ _._-____ lFY. _ - ._- 7 . __. S)/Ggi1NTEE(S)-APPLICATION FOR PROPERTY'Tr1X DEDUCTIONSc16ENTIFY ALLiTEMS THAT APPLY__ _. Kristi D Bruce '/1 .,.,,.,.c,y,,rs on conveyance document Buyer 2-Name as appea on co ey cedon 914 N POLK DRIVE Address(Number and Street) Address(Number and Street) OAKLAND CITY, IN 47660 MAY 2014 AL O M (• AYA tWITOR THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF YES NO CONDITION I YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary YES 3. Homestead residence? Provide complete address of primary I I 0 4.Solar Energy Heating/Cooling System residence,including county: ❑ SI 5.Wind Power Device 914 N POI K DRIVE Address(Number and Street) ❑ SI 6. Hydroelectric Power Device OAKLAND C TY, IN 47660 GIBSON ❑ N 7.Geothermal Energy Heating/Cooling Device Ciy,State Zl _ode County El 2.Does the buyer have a homestead in Indiana to be 111 SI 8. Is this property a residential rental property? vacated For this residence? If yes,provide ❑ N 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 i�ny all/c�oun counties.) Address(Number and Street) do/(/Q —ao/— 6�-�' . YO(..5 - 00 2 Kristi D. Bruce City,State ZIP Code County E-mail Primary property owner contact name