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Homestead_Heldt (4)
INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1804724 Paget D.PREPARER Britany Nicole Barnes Searcher Preparer of the Safes Disclosure Form Title 226 W.Broadway Broadway Title Inc. Address(Number and Street) Company Princeton.IN 47670- 812-386-1687 patti.bti@mw.twcbc.com Ctty..State,and ZIPCnde Telephone Number E-mail jE;$ECCER(S)%GRANTOR(S) . .. _ `'. ' -- -' .L.,': -, - .. . _. z .'=j- r_� _ . .-. .- __ Jerry L Simpson Anita M Simpson Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 511 E.Vine St 511 E.Vine st Address(!:umber and Street) Address(Number and Street) Under penalties of perjury,l hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and corn a lete as required by law,and is prepared in accordance wi C 6-1.1-5.5,"Real Property Sales Disclosure Act". Sign, ere of Seller ' {— . signature er / s f I / �/ i '� - —/ �.r . l - AA s ,s --s / TAU'ER(S)/GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS-.IDENTIFY ALL ITEMS-THATAPPLY-- - Corey M Heldt Shelly Heidi Buyeconveyance rs-Name as appears on conveyance document Buyer Z-Name as appears on conveyance document 805 E.Vine st 805 E.Vine St Er? Address(Number and Street) Address(Number and Street) Fort Branch,IN 47648- Fort Branch, IN 47648- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FUR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT A� Y 7. YES NO CONDITION YES NO CONDITION �t tltl-S�N Cwi)Nry © ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead AUDITD; residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System residence,including county: ❑ ILI 511E VINE ST 5.Wind Power Device Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Fort Branch,IN 47648 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device City.State ZIP Code County ❑ CI 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 ❑ ❑ 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) City,State ZIP Code County Primary property owner contact name E-mail