HomeMy WebLinkAboutHomestead_Johnson (12) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARERS'_ _ -7,1-4-;
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Farm Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE. IN 47715 812-402-4553 CHRISTINA(dREGIONAL-LT.COM
City.State,and ZIP Code Telephone Number E-mail
'E.SELLER(SI/GRANTOR(S):_ _. . - _ _ .. - . _;- - .._ _-__ = `.•..-
Anthony R Hughen Michelle R Hughen
Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
3'03 c loc.vt4-51-• ,03 S. Fovr+h S/- •
Address(Number and Street) Address(Number and Street)
Pei'leek n t .10 q-7t-70 }fir i n c e.i-o n, I N 47(0 7 0
Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
andm et requi ed y law,and is prepared in accordance with IC 6.1.1-5.5,"Real Pro Sales Disclosure Act".
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Signature o Ile Stgnatur of Seller } \ ���
Anthony R Hughen 07/25 12°1 f Michelle R Hughen -1)�7 1G01 `►
Printed Name of Seller Sian Date(M.M/DO/iYYI) Printed Name of Seller Sian Da (M.M/OD
:F:BUYER(S)/GRANTEE(S)_APPLICATION-FOR PROPERTY TAXDEDUCTIONS-IDENTIFY:ALL ITEMS.THAT,APPLY __. - _-_. . ._.
Andrew P.Johnson Lydia G.Johnson
Buyer l•Name as appears gn conveyanc document Buyer 2-Name as appears on conveyance document
cog i S. I(, tc
e orek (a9) 5. Concord
Addumberand Street) Address(Number and Street)
YrIncif0)1 t 2--f") 17670 I rtnrvfo /n) 4'7(.67 0
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE T TAPPPLLY.��rr
YES . NO CONDITION I YES NO CONDITION H A II
0 ❑ 1.Will this property be the buyer's primary ✓'"❑ 3.Homestead 1Y LET-)
residence? Provide complete address of primary ❑ 12 4.Solar Energy Heating/Cooling System
sidence,In di a county: ❑ 0 Wind 3 0 2014
/ nI � y�_ i () (R - 5.Wind Power Device
CO `dlress(,NumberalndSuj:t)Gd., 4 7 6 �J� �., ❑ 0 6. Hydroelectric Power Device
/r*.,iP.e�cnJf"'�� `1" 7�0 7 0 Y-""� '�' ❑ IA 7.Geothermal Energy a Device
City.State Z Code County GLBS
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.1s this property a I��Ir1e If�i6111Te15t91-jbgppr{�y?
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)
Ci y,State ZIP Code County
a6-1∎- l y- io(- nee. 4101-( '
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Primary property owner contact name E-mail