HomeMy WebLinkAboutHomestead_Dilbeck INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D..PREPARER - - , _ -
Sherri S Hudson Closing Manager
Preparer of the Sales Disclosure Form Tide
501 Main Street,Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000 sherri.hudsoneieffbosse.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S) - . •
David R Dilbeck Helen S Dilbeck
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document •
11492S 150 W 11492 S 150 W
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639 Haubstadt IN 4763
Under penalties of perjury,I hereby certify that this Sales Disclosure,to a best of my knowledge and belief,is true,correct
a complete aas quires ed by law,and is prepared in accordance with I -1 -S.S,"Rea prop Sal s Disclosure Act".
Signature of Seller ignatore of Seger
$41/V
David R ame of Se la-2.5-1,11. Helen S Die fck
Printed Name of Seller Sian Date{x.4/DD/YYYIT Pn'nted,Vameof5dler Sign v.V D
F.BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY-TAX DEDUCTIONS=IDENTIFY ALL ITEMS T T-
, Adam J.Dilbeck Annie M. Dilbeck 2 C P^•ar' u.,..."^•.. conveyance document Buyer 2-Name as appears on conveyance document AUG ` 9 2014
3516E505 3516E50S_
Address(Number and Street) - Address(Number and Street) ,
Princeton. IN 47648 Princeton IN 47648 ASIER)i:
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES fjp Cn.N'QfON
❑ 1.Will this property be the buyer's primary Cll. ❑ 3.Homestea
residence? Provide complete address of primary - u lJ 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ Fl 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Cade County
2( ❑ 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 ❑ SI 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.
351i 1 E • 50 LS . Not available in all counties.)
Address(Number and Street)
?r(nce_-(ah_ - I NS 41(01 O G„Sasnn A Co _i8 ) /-3 00 -OW. 150Z -0 J,5
City,State ZIP Code County
Primary property owner contact name E-mail