Homestead_BrownIN
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
4O.PREPARER
Jeff Dodson Title Attorney
Preparer ofthe Sales Disclosure Form Title
Lincoln Ave. Clear Title Company
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Email
E. SELLERS GRANTORS .
Dotie L Anderson
Sellerl - Name as appears onco%veyance document Vcc,,, r-1p4.5
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Seller 2- Name as appears on conveyance document
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Address (A'umber and Street)
Address (Number and Street)
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Email
Telephone Number E -mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and mplete as require by law, and is prepared in accordance with IC 6- 1.1 -S.5, "Real Property Sales Disclosure Act ".
g.mare af.Seller Signature of Seller
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Pr Nameo Seller SharLWOVIIDDAYM Printed Name o Seller Sian Date fMM /DD
BUYERS GRANTEE (S - APPLICATION FOR PROPERTY TAX D CTIONS- IDE LL ITEMS THAT APPLY
Kevin G. Brown
Sandra Brown
Buyer l- Nameosappwno onveyance document
Buyer 2- Nameasappears on conveys ce document
4859 5.1100
m rand Street)
Ad h'umberand Street)
land City, IN 47660
Oakland City, IN 47660
,
E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. I DEN71 FY ALL OF THOSE THAT APPLY.
YES NO CONDITION ES NO CONDITIO
✓ ❑ 1. Will this property be the buyer's primary
❑
✓❑ ❑ 3. Homestead
residence? Provide complete address of primary
ar nergy Heating /Cooling System
residence, including county:
F] ❑ S. Wind Power Device
4859S 1100E
❑ ❑✓ 6. Hydroelectric Power Device
Address (Number and Street)
Oakland City, IN 47660 Gibson
❑ Q 7. Geothermal Energy Heating /Cooling Device
❑ ❑✓ 8, Is this property a residential rental property?
�-C�n(y, State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be
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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 coun;' :
below. Please see instructions for more information.
/y9/G d O'b" L rns5
Not available in all counties.)
&G)- A0 -01- 10 G - 600 I
Address (Numherand Nee' UV� Ne �� }7(F33 �io5e(I
Chy Swte ZlP de C
unry
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Primary property owner canto[[ name Email
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 ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
bein f�
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®mture ofBuyerl SignaNre�Spous
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