HomeMy WebLinkAboutHomestead_Williams (42) INDIANA SALES DISCLOSURE FORM SDP ID: Page 2
D.PREPARER
Stephanie Miler Closer
Preparer of the Sala Disclosure Fenn Title
4962 Lincoln Ave. First Advantage Title
Address(Number and Street) Company
Evansville,IN 47715 812-490-8485 theteam(oi7firstadvantagelitle.com
City State,and ZIP Code Telephone/lumber E-mail
--E'SELLER(S)/GRANTOR(5) c '.,.. _ _ . _ -
}cab Holdings 2 I I C
Seller.'-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
16 Rerryhill Road Suite 200
Address(Number and Street) Address(Number and Street)
Columbia SC 29210
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 opener
Jonathan Buerkert Authomed Signer 11/210014
hinted Mimeo].Seller Slpn Date(ILN/BD/YYYY) Printed Name of Seller SOn Date(WFD/Yrni
Fr8UYER(SI/GRAN•CEE(S):`ARP.LICATIONlFOR'CROPERTY.TAX•DEDUCTIONS f lDENTIFY'ALl1ITEMS.THAT'APPLY.
(Jessio L Williams James W Adams
ear appears on come once document Buyer 2-Name as appears on conveyance document
L4 ) ;l Iex/ wA S
Writs(NUmber and(Street)� \ n� Addrm(Number and Street)
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I CS M CA—) I h t 4/ ON" s o e o_ci w ST PIS I v`
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. T
YES NO CONDITION YES NO rMNORION e r
❑ 1.Will this property be the buyer's primary j' ❑ 3.Homestea IL ED
residence? Provide complete address of rimes
oar Energy eating Doling System
rest ence, eluding co ty: ❑
IM- awi 44 o S.Wind Power Device DEC S 2014
M�yddr—eas(Number"and Street -t ,""l ❑ Q 6.Hydroelectric Power Device
rf,Yl[F ,u) I J � 1(1l 0 61 bS0) ❑ Q 7.Geothermal Energy Heating/ °ling l vi
City,State ZIP Code County i
❑ [" 2.Does the buyer have a homestead in Indiana to be ❑ Q 8.Is this property a residents e, /�r���t�l'r u /TOR
vacated for this residence? If yes,provide ❑ Q 9.Would you like to re aSONs HMMBO[sYfm-VMS
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
N• • •• - ' • nun les.
Address(Number cad Street)
old -/2 - 07 - /0 3 -000./to . 0)..3)
City.Rate ZIP code -aunty
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