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HomeMy WebLinkAboutHomestead_Flaningam INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D..PREPARER_ - -- _ r -=-- - - ----- --- LANA C. HARPER CLOSER Preparer of the Sales Disclosure Form Tide 19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES. LLC Address(Number and Street) Company EVANSVILLE,IN 47708 812-468-8485 City,State,and ZIPCode Telephone Number E-mail E.SELLER(S)/GRANTOR(S) . _----.._ DAVID C RFGHTEL KAREN L BEGHTEL Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 393/ bj2ovS 3C131 W 2ov S . Address(Nur,ber and Street) Address(Number and Street) 014f(4 Elie I I/J 976"5 OurnR) lc in) 4-IUDs Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct m , co -.. - a r quired by law,and is prepared in accordance with IC 6-1.1-5.5 Real Pro rty Sales Disclosure Act". Vie. ` �' -ignawre a,Selle forma 1� 131. e, `i- EC {t lE(_ -" ; . • r1- ( O , ' Primed Name olSeller Sian Date Amp TMI Printed Name of Seller .Sign late( M/ODO nl VF.BUYER(S)/GRANTEE(S)-APPLICATION FOR.PROPERTY TAX-DEDUCTI ONS-IDENTIFY-ALL ITEMS AT APPLY _ - - _.-_ CINDY K.FLANINGAM ft�//�j.J, Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance men 03 5 . !A u t k �-E .- ���[[[[[[ �, a Address(Number and Street) Address(Number and Street) \O„` ta)co fl\ t', 'L\ 1 li _ HOv7 TYA(/n-_ TES NO CONDITION YES NO CONDITION «/� Iti El I.Will this property be the buyer's primary 0 ❑ 3. Homestead UR residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System resid ace,including county: ❑ Q 5.Wind Power Device ()3t3. tociSt IQres(Numb.jund Str\eet) 'Ni 000 ❑ Si 6. Hydroelectric Power Device ( '�4/`lp--}1j-7U`1 I\ ❑ SI 7.Geothermal Energy Heating/Cooling Device City,State ZIPCode County r a...2. ❑ Q 8. Is this property a residential rental property? Does the buyer have a homestead in Indiana to be 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) //)/q(//� City,State ZIP Code Counry _ a?/,/a/ Co Di-O�� Primary property owner contact name E-mail