HomeMy WebLinkAboutHomestead_Zunk (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2
� D. PREPARER
Kathy Masterson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com
City, State, and ZIP Code Telephone Number E-mail
E`SELLER(S)'/"GRANTOR(S):
Richard W. Smith Monica J. Smith
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
12860 S Sunset Dr 12860 S Sunset Dr
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
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".
Signature of Seller tSigneture of Selle°
Richard W. Smith 5/22/2014 Monica J. Smith 5/22/2014
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
-F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Hannah R.Zunk
Buyer I-Name as appears on conveyance document Buyer 2-Name as appe,Zloty a 1 n a c
12691 S. Scottsdale Drive
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 ,
I.THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPetB8Q WOBy/ ;TJ d1iAT APPLY.
YES NO CONDITION YES NO CONDITION FFtC
❑ G1-'/Will this property be the buyer's primary 4 ❑ d'i. Homestead
residence? Provide complete address of primary
I ❑ D 4. Solar Energy Heating/Cooling System
1 residence, including county:
❑ RI 5. Wind Power Device
690 East Eisenhower Lane
Address(Number and Street) ❑ El 6. Hydroelectric Power Device
Haubstadt, IN 47639 Gibson' ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ ❑ 8. Is this property a residential rental property?
❑ 2 /Does the buyer have a homestead in Indiana to be ❑ 5 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
•
Address(Number and Street)
2 • • rf9 -3a -ion-o00 7'90 0 a4/
City, State ZIP Code County Primary property owner contact name E-mail