HomeMy WebLinkAboutHomestead_Higgins (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:PREPARER :,,_.•. :.
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE,IN 47715 812-402-4553 CHRISTINAeREGIONAL-LT.COM
City;State,and ZIP Code Telephone Number E-mail
-E.SELLERS : GRANTOR(S). -
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Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
— /192 3 $ 44L ISO 41 SFP l 6 2014
Address(Number and Street) �/ 7635 Address(Number and Street) —
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 p epared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Printed Name of Seiler Sian Date(.ea/DD/1'YYY) Printed Name of Seller Sian Date(M.N/DD/Yml
IIF.BU : , ' '` ._„,e TION FOR'PROP.ERTYTAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY ` - - -
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Buyer t-,vume at appears on cony Buyer me as appears on conveyance document
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Addrgs(Number and st4" Address umber and St �� I 1 4�S n �'l
�/ tf/y�6s�9dt L� �G39 4l A\'0 -‘11 N ( /V/ ✓l
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. ID NTIFY ALL OF THOSE THAT APPLY. ,
YES /, I
❑(/ CONDITION CONDI�tp,
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary 12 4.Solar Energy Heating/Cooling System\ esidence,including county: ❑
\\57 5 ‘60 _\ 5.Wind Power Device
AA dress(Number and Street) W ❑ 0 6.Hydroelectric Power Device
, 1 t3 U"1(Q'3Ct e---Uki OC\ ❑ 0 7.Geothermal Energy Heating/Cooling Device
City, County
❑ Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ NI 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: •• • ' ' '• • •• 'nstructions for more information.
Not available in all counties.
Address(Number and Street)
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City,State ZIP Code Cou -
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