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HomeMy WebLinkAboutHomestead_Fortner INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ,:D:PREP.ARER . .: _. - - Christopher E.Carl Attorney at Law Preparer of the Sala Disclosure Form Title 101 Plaza E. Blvd. Suite 101 _ _ True Title Service, LLC Address(Number and Street) Company Evansville. IN 47715 812402-6555 Closings ntruetitlein.com City,State,and ZIP Code Telephone Number E-mail ,E.SELLER(S)/GRANTOR(S) _ --- -- Jason Eugene Gilliland Trixie I ee Wildt Seller I-Name as appear on conveyance document Seller 2-Name as appears on conveyance document 1050 S Old State Road 65 1050 S Old State Road 65 Address(Number and Street) Address(Number and Street) Princeton IN 47670 Princeton IN 47670 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and c:- plete ate.equired by I.w,and is pre•r : r n accordance with IC 6-1.1-5.5,"Real/Property Sales Disclosure Act". ip Amp•re of Seller Signature of Sel er _.:t i .-r- ... • I • Trixie Lee Wildt 8/29/2014 Printed Name of Seller Sion Date(MM/DD/rrvf) Printed Name of Seller Sian Date(MM/DO/MY) F.,BUYER(s)/GRANTEE(S)-APPLICATIONIEOR PROPERTY TAX DEDUCTIONS-IDENTIFYALL.ITEMS THAT APPLY Shawn Dewavne Fortner Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1787 W 100 Lyle Station Road yg ""'' ' Address(Number and Street) Address(Number and Sweet) ® ri 11 i' Princeton. IN 47670 T 4 f� THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE• AT APPL . YES NO CONDITION YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary ❑ ❑ 3.HomeSMNON COON I Y HUldl I tat. residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ 5.Wind Power Device 1050 S Old State Road 65 Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device Ciry,State ZIP de 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 ❑ Z 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) I I /� 1//‘/1 �l1tt� Shawn Dewayne Fortner91p 1 1 J f-�fWiel-oisq 6-91-c Ciry,State ZIP Code County Primary property owner contort name E-mail