HomeMy WebLinkAboutHomestead_Blankenberger INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services. LLC
Address(Number and Street) Company
Evansville,IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) . • ' -
- .Sharon K Wilson
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
203 S West St
Address(Number and Street) Address(Number and Street)
Ft Branch IN 47648
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
omplete a required y law,his prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Sharon K Wilson 10/22/2014
Printed Name of Seller Sian Date(MM/DO/YYYY) Printed Name of Seller Sign Date(MM/DD/YtYI)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS=IDENTIFY ALL ITEMS THAT APPLY -
("Jergmv Blankenberngj)
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
115 S.Damosa Dr.
Address(Number IN and63eeQ Address(Number and Street) ����T
Haubstadt, IN 47639 FILED
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. - L •
YES NO CONDITION �YE�S NO CONDITION ��}J
N ❑ 1.Will this property be the buyer's primary (I' I n 3.Homestead 7 7JV 4l4
residence? Provide complete address of primary ❑ IN 4.Solar Energy%1ANSWVstlirIPITOR
residence,including county: ❑ gi
203 S West St 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Ft. Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 2.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 ❑ 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)
,?‘ -/e-/3 - 4403 -OOO, Jay —o016
City,State ZIP Code County
Primary property owner contact name E-mail