HomeMy WebLinkAboutHomestead_Besing INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER'. . ,. r .
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services,LLC
Address(Number and Sweet) Company
Evansville. IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail
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E.SELLER(S)/GRANTOR(S)• .
Neal F Walther Debra K Walther
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
20005 Liedecke Rd Ant 6205 20005 Liedecke Rd Apt 6205
Address(Number and Street) Address(Number and Sweet)
San Antonio TX 78264 San Antonio TX 78264
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete�asf eeqq 'red by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/ f. %1/.t(�G'LRv 2-J3'1 S )e!i-eAA .e. . /L JAI c(tt,LtA1 /-/3-/c
Signature ofSeller Signature of Seller
Neal E Walther ■-• . . s - .-
PrintedNameofSeller Sign Date(MM/DD/YYYY) Printed Name of Seller I 1 1 tapl ./
F.BUYER(S)/GRANTEE(S)a APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM', •j • 1 PLY J'f� riYY)?
/Brooke LeAnne Besing") Shawn Eric Besing
G buyer I-Name afappmrs on conveyance document Buyer 2-Name as appears on conveyance documenJAN 20 2015
PO Box 341 POBox341
Address(Number and Street) Address(Number and Street)
Haubstadt. IN 47639 . •
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 .. . -
1g ❑ 1.Will this property be the buyer's primary £ ❑ 3.Homestead M
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System
residence,including county: ❑ ig
202 S Mill St 5.Wind Power Device
Address(Number and Street) ❑ 12 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson
City,State ZIP Code County ❑ 7.Geothermal Energy Heating/Cooling Device
El 4 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 ❑ 12 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)
.16 - /7 -fl -an -noo. 54,6 -02.A
Ciry,State ZIP Code County
Primary property owner contact name E-mail