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Homestead_Simpson (2)
INDIANA SALES DISCLOSURE FORM SDP ID SDO ID 1804822 Paget --- Britany N Barnes searcher Preparer of the Sala Disclosure Form Title 226 W.Broadway Broadway-Tnle Inc Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 patti.bti @mw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E'SELLER(S)%GRAN.TOR(S) ;` ,:' ,,:: z - - ` Chris J Goodman Trida E Goodman _ Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 4428 S 700 West 4428 S 700 West Address(Number and Street) Address(Number and Street) Owensville,IN 47665- Owensville,IN 47665- Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete . required by law,and is prepared in accordance with IC 6-1.1-55,"Real Property Sales Disclosure Act". I, - •r. ,.f /AS ,_r4i1lNLCNV 'gn tre BSc!:7 ignature of Seller hn$ J 600DMA ii 03/01/212L5_, `-j'Tf :Ct r, eeock �1'f 0 3/(O/J5 Po;,rM N--.preen.- O•• m"mm, P,+r.•r.Y"•-."rearm Cfrin nn.nvuam gm', F.-BUFER(SI/GRANTEE(ST APPLICATION.FOR-P.ROP.ERTYTAX:DEDUCTIONS IDENTIFI AI:L.ITEMS..THAT"APPLI "c , -- C Jerry L Simpson Anita M Simpson Buyer I-Name as appears on conveyance document Byer 2,Name as appears on conveyance document 511 E Vine st 511 E Vine St. Address(Number and Street) Address(Number and Street) Fort Branch,IN 47648- Fort Branch,IN 47648- 14 YES NO CONDITION YES NO CONDITION tlSOM J © ❑ 1.Will this property be the buyer's primary © ❑ 3.Homestead OURTY residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling Systel�p residence,including county: /TOR . ❑ © 4428 S 700 WEST 5.Wind Power Device Address(Number and Sweet) ❑ © 6.Hydroelectric Power Device Owensville,IN 47665 NOT APPLICABLE ❑ © 7,Geothermal Energy Heating/Cooling Device City,State Z1PCode County ❑ )0 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 i I!counties.) Address(Number and Street) n 1/ City.Smte ZlP Code County �� /D'S �0— 0 0/ 7?S w' Primary property owner contact name E-mail •