HomeMy WebLinkAboutHomestead_Moore INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
r ;D:PREPARER .
Ray M. Drulev Attorney No.4759-26
Preparer of the Sales Disclosure Form Title
505 N. Church Street. PO Box 146 Law Office of Ray M. Drulev
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 druleylaw(a)vahoo.com
City,State,and ZIP Code Telephone Number E-mail
.E.SELLER(S)/GRANTOR{S)'. _ . -.,- ,.. --- -- --- -- - - - - . _.
Karla Goodman Pers Rep Tony Fugene Riley Pers Reo
Seller 1-Name as appears on conveyance document Seller 1-Name as appears an conveyance document
6462 W Old Princeton Rd 105 N Scott Street
Address(Number and Street) Address(Number and Street)
Owensville IN 47665 Owensville IN 47665
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 a 6-1.1-5.5,"Real Prop ales Disclosure Act".
Signature ofShcer Signature Seller
Karla Goodman Pers Reo June 9 2014 Tony Eu ene Riley Pers Rep June 9 7014
Printed Name of Seller Sian Date(MM/oD/YYYI) Printed Name of Seller Sign Datp,(B_N/DDAnv)
`F..BUYER(S)'/GRANTEE(S)'-APP.LIGATIOWFOR PROPERTY;FM .DEDUCTIONS;IDENTIFY.ALL ITEM "I9j7j(1:. 1- tp4111 " "
Robert L. Moore IRS-( yl
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on conveyance acumen:
108 S. Mill Street 'UN 17 2(114
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSEETTHAT APPLY.^ ^� �/y.�
YES NO CONDITION Nn rnvneria _ ✓ 474p"VOI-OW -l.99-04
Q ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead ((//\\' Q(0-q-a -Qteta'4-Co
residence? Provide complete address of primary • 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
510 W Brummitt
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson
State ZIP Code County 7.Geothermal Energy Heating/Cooling Device
Ciry,
El 2.Does the buyer have a homestead in Indiana to be ❑ NI 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 51 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.
108 S. Mill Street Not available in all counties.)
Address(Number and Street)
Owensville, IN 47665 Gibson
City,State ZIP Code County
Primary property owner contact name E-mail