HomeMy WebLinkAboutHomestead_Nielsen INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
..__ -. -
D:PREPARER. . _ ` - ` `
Stacey Salzman Closer
Preparer of the Sales Disclosure Form Title
4962 Lincoln Ave. First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 812-490-8485 theteamefirstadvantagetitle.com
City,State,and ZIP Code Telephone Number E-mail
E.SELEERJS)/GRANTOR(S)_. -: :1_4-* -- -- - -
Dennis I I awalin Plana K I awalin
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
421 S Soring St same
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
City,State,and ZIP Code City,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
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 prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Dennis L I awalin 10/P/ /2014 Dana K I awalin
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign a D/YYY1)
F.BUYERS)/GRANTEE(S)-APPLICATIONIEOR'PROPERTY TAX DEDUCTIONS-:IDENTIFY-ALL ITEMS THA t:Y8i - _T- --
� , 12.8 2014
ltvvan K Nielsen Jamie T Nielsen
) �conveyance document Buyer 2-Name as appears on conveyance document
f-t N same I a. .i
( ress(Number and Sweet) ! '' II Address(Number and Sweet) GIBSON COUNTY AUDITOR
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
7) ❑ 1.Will this property be the buyer's primary ( 171 3.Homestead
residence? Provide complete address of primary -❑ ❑/ 4.Solar Energy Heating/Cooling System
- ■ /
/Preside-4e
- ❑ 5.Wind Power Device
• I" '1 (Puri ` ❑ 0 6.Hydroelectric Power Device
■ ►•. Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code I 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 ❑ E 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)
n26 - // -/.- tf00 -000 .643 - 0 d7
City,State ZIPCode County
Primary property owner contact name E-mail