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HomeMy WebLinkAboutHomestead_Ward (3) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 DP P,:EI AREA Laura Rininger Closing Coordinator Preparer of the Sales Disclosure Form Title 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-moll SELLER(S)'/GRANTOR(S)LL- — _ • — TT- E_May Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document _270016th St. S#651 -_- _-- Address(Number and Street) 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 prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller 1J 0 J Signature of Seller Cant F May by 1 isa A May his AIF 12/12/2014 Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/mY) THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION ❑ 1.Will this property be the buyer's primary El 12 3. Homestead , R1/4)R1/4)residence? Provide complete address of primary 4.Solar Ener residence,including county: ❑ i 514 N Polk St 5,Wind Power DevicnneCCCC 11A Address(Number and Street) ❑ IN 6. Hydroelectric Po%at�Ydeii — Ft. Branch. IN 47648 Gibson 7.Geothermal Ener% Heatin' C. • :evice City,State ZIP Code County s • e1 ❑ 0 2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a •••+F•'n'CA at property?l in vacated for this residence? If yes,provide ❑ Fl 9.Would youffila$®P4alaTYx staremenntts �for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. �n-.JI^ r�•� Not available in all counties.) Address(Number and Street) U W - IR-13 �OI_ ono 3 13 - ©ab City,State ZIP Code County O ` ll ono Primary property owner contact name E-mail