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HomeMy WebLinkAboutHomestead_Thach INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER " Mark K. Phillips Attorney Preparer of the Sala Disclosure Form Title 114 S.Third Street Address(Number and Street) Company Boonville, IN 47601 812-897-4400 City,State,and ZIP Code Telephone Number E-mail E:SELLER(S)/GRANTOR(S) -- - .. David H Smith Peggy S Smith Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 305 N Fmhree Street 305 N Fmbree Street Address(Number and Street) Address(Number and Street) Princeton IN 47670 Princeton IN 47670 City,State,and ZIP Code City,State,and ZIP Code S/&- 455- / 7 0142 812-455-1922 Telephone Number E-mail Telephone Number E-mail Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct umplete as required b. and2 law,and is prepared in accordance wait 'IC 6-1.1-5:5,"Real 71 rty Sales Disclosure Act". Signature of Seller Sianab/ Seller David H Smith Peggy//' mith Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name o(Seller Sian Date(MM/Do/YYYI) F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS,-IDENTIFY ALL ITEMS THAT APPLY Duy Huu Thach Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 2801 W. Broadway Street Address(Number and Street) Address(Number and Street) Princeton, IN 47670 City,State,and ZIP Code City,State and ZIP Code R a- 3o9- 49 la Telephone Number E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS LPROPERTY. ID CONDITION OF TII T T PLY. l YES NO CONDITION IgC�J' (71 D 1.Will this property be the buyer's primary [ ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heyaggeol2regystern residence,including county: 305 N Embree Street ❑ P S.Wind Power Device Address(Number and Street) ❑ Q 6.Hydroelectric •ffl er 0gr+►1/g Princeton, IN 47670 Gibson ❑ 0 7.Geothem®1 mrudiq.I-jrig , e bliitbRevice City,State ZIP lode County ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 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) / • 4 I- Ia- 1^1 '-r; 22. Tt/ I/S _ Duy Huu Thach fa 11 C.M.YJ\l.1{ l]/`�/) {t({jJ City State ZIP Cade County Primary property owner contact name 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".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.) tYv i / Signature of Buyer! Signature of Buyer2/Spouse Duy Huu Thach Printed Legal Name of Buyer l Sign Date(MAI/DD/YYYY) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DO/YYYY) 0 29C) TN 3 8oc1,. Last 5 digits of Buyer l Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security License/ID/Other Number Number License/ID/Other Number