HomeMy WebLinkAboutHomestead_Clevenger INDIANA SALES DISCLOSURE FORM SDF ID: Pa e•2 .
Jamie Perry Closing Services
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 jamie-perry regionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
:E.'SELLER(S)/GRANTOR(S) H . . . _ . . - _ -
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
City,State,and ZIP Code City.State.and ZIP Code
Telephone Number E-mail 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 required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
52,? ol)Kor Se.,c_oncktf
Signature of Seller Signature of Seller
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
-F. I I' ' - d TEE(S)-APPLICATION.FOR PROPERTY TAX DEDUCTIONS=IDENTIFY•ALL ITEMS.THAT APPLY`' - . _ _ 2-
/Ryan C.Clevenger
(\ Buyer]-A'aars on conveyance document
Buyer 2-Name as appears on conveyance docume
•
\
D
RR1 1 Box 234A _
-Address(Number and Street) Address(Number and Street)
Wayne City, IL 62895
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P••• . ' • '• a'ALL OF THOSE THAT APPLY. LIDO'OR
YES NO CONDITION YES NO CONDITION p1EiSON COUNTY A
0 El 1.Will this property be the buyer's primary ip n 3. Homestead
residence? Provide complete address of primary S „ • , - s- 3 -- ing/Cooling System
residence, including county: ❑
5.Wind Power Device
1005 1(2 S Center Street
Address(Number and Street) n 0 6.Hydroelectric Power Device
Fort Branch. IN 47648 Gibson n 5• 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 5 2.Does the buyer have a homestead in Indiana to be n 0• 8.Is this property a residential rental property?
vacated for this residence? If yes,provide n 0• 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)
ot-4A'd:-a. ca c/7- act
City.State ZIP Code County
Primary property owner contact name E-mail