HomeMy WebLinkAboutHomestead_Gries (6) INDIANA SALES DISCLOSURE FORM SDF ID: 2014 Page 2
D. PREPARER
• 1-2rfes61 friCirr t/J Escrow Officer
ii Preparer of the Sales Disclosure Form Title
Y
1 605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
'I Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 iri?;q f @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
James T. Czoer
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
650E 1025 S
Address(Number and Street) Address(Number and Street)
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
I n compt as r quired by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
4%//,9fgnature of`d err Signature of Seller
1 James T. Czoer 7/3/2014 7/32014
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
Ryan Gries Lauren Gries
• Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
3440 W Baseline Rd 3440 W Baseline Rd
Address(Number and Street) Address(Number and Street)
Evansville, IN 47720 Evansville, IN 47720
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY A F ISE T7
Y7. NO CONDITION YES NO CONDITION 1
❑ 1. Will this property be the buyer's primary ,f..l ❑ 3. Homestead •residence? Provide complete address of primary 0 p 4. Solar Energy HeatingQling 8
residence, including county:
❑ Et 5. Wind Power Device
1340 W Chukar Hollow ,'
Address(Number and Street) ❑ ❑ 6. Hydroelectric Power j ice 4 ,i
_ Wlmllli
Haubstadt, IN 47639 Gibsori ❑ ❑ 7. Geothermal f(r�:,s --ttlwi, •. t �ej�ceR•
ity, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 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.
3440 W Baseline Rd Not available in all counties.) �yt �{
Address(Number and Street) ,1 I / / (� oa 1
Evansville IN 47720 /and"//1)01-'9' A
Q(o I 3�O- 3oc� - &O' ' S S^
City, State ZIP Code Cou ly Primary property owner contact name E-mail