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HomeMy WebLinkAboutHomestead_Kelley INDIANA SALES DISCLOSURE FORM SDI'ID SDO ID 1785350 Page 2 D.PREPARER .- - - - Kimberly A.Lewis Office Manager Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 kim.bti @mw.twcbc.com Cite•State.and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S) ' . - _ _ - - - - - - Ryan N.Allen Jami L.Men Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document 804 W Elm St 804 W Elm St Address(Number and Street) Address(Number and Street) Haubstadt,IN 47639- Haubstadt,IN 47639- Under p alties of perjury I reby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co pl to as r 4 ired�y v,and is prepared in accorda • i IC 6-1.1-5.5,"gepl�P� roper Sales Disclosure Act". !fi r CLt\ r J/�/' Signature Selle n ) gnvm eller ' �yal7 N. 1(' sl 7-'23-/Li . .1i i ,r c/fiG.� 67' '7D/f/ P-i-r=+f A'a-arrcoaa• O"n Onef vrnMfrryn Pr+n•H 1•-ro rrbnor Cl,, 'sync F.BUYER(S)/GRANTEE(S)-APPLICATION.FORPROPERTYTAXDEDUCtION'S=IDENTIFY ALL ITEMS THAT-APPLY. _ Michael R.Kelley Buyer I-Name as appears an conveyance document Buyer Z-Name as appears on conveyance document 632 East 125 South Address(Number and Street) Address(Number and Street) Haubstadt,IN 47639- THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE APPLY. YES NO CONDITION YES NO CONDITION © ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead L E D residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating Cooling System residence,including county: ❑ © 5.Wind Power Device JUL 9 4 2014 114 S.VONNA LANE Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Haubstadt,IN 47639 GIBSON 7,Geothermal Ener: A i '• i vice City State ZIP Code County ❑ © - fl•I• -rat Ie• ❑ © 8.Is this prop S€N1i•t=a it• 1 At i ❑ ID 2.Does the buyer have a homestead in Indiana to be -I uR' vacated for this residence? If yes,provide ❑ ❑ 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(1'urnberand Street) aCo^ 1g 3 -E 0- �/D3-000.161 City,State ZIP Code County Primacy property owner con tact name E-mail