HomeMy WebLinkAboutHomestead_Brown (2)INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D::PR6PARER `,`* - ,..;...:. _ i., r,_ .. " tZ, -
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_ Michelle Haynes Closing Agent
repu arafthe Sales Disclosure Form Title
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01 Main Street, Ste 101 Bosse Title Company
Address(Numberand Street) Company
Evansville, IN 47708
Email
E. SELLER S / GRANTOR 5
Daniel Olds
Seller 1 - Name as appears on conveyance document
12318 105th Street
Seller 2 - Name as appears an conveyance document
Address (Number and Street)
1 argo FL 33773
Address (Number and Street)
City, Smtt and ZIP Cade
City, Stare, and ZIP lode
E -mail
Telephone Number E -mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
required �b/y law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
and co(m� fete as / re
Signature of Seller Signature of Seller
Daniel Olds 1112812011
Printed Name o Seller Sion note MM DD Printed Name o(Seller Sian Date fMM /Da/In
F: BUYERS GRANTEE S -- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY,ALL ITEMS THAT APPLY
Robert W. Brown
Buyer 1 - Name as appears on conveyance document
Buyer 2 - Name as appears on conveyance document
19 Brentwood Circle
Address (Number and Street)
Address (Number and Street)
Evansville. IN 47715
try, State, and ZIP Code
9
City, State, and ZIP Code
E -moil
Terminate, Number E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
❑ 1. Will this property be the buyer's primary
✓❑ ❑ 3. Homestead
residence? Provide complete address of primary
❑ ❑ 4. Solar Energy Heating /Cooling System
residence, including county:
❑ ❑� 5. Wind Power Device
5194 N 75 E
❑ ❑� 6. Hydroelectric Power Device
Address (Number and Street)
Patoka. IN 47666 Gibson
❑ Q 7, Geothermal Energy Heating /Cooling Device
❑ ❑� 8. Is this property a residential rental property?
Ciry, State ZIPCode County
® 2. buyer have homestead in Indiana to be
Q Does the a
vacated for this residence? If yes, provide
❑ n 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 far more information.
M�
Not available in all counties.)
a� ossg- Da4�DOa•031-D18
Address (A'umber and Street)
� �-
City, State ZIP Code County
Primary property owner concoct name 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 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
being filed.)
Signs re ofBayerl signature 0f8vyer2 1Spoe
Last 5 digits ofBUyer l Driver's State Last 5 Digits of5ocial Security Number Last 5 digits ofBuyer7 /Spouse Driver's State Last 5 Digits of Social Security
License /ID /Other Number Number License /ID 10ther Number