HomeMy WebLinkAboutHomestead_DuncanINDIANA SALES DISCLOSURE FORM snF In.
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Preparer o(Ne Safes Disclosure Farm Title '
Address l S
Company
119 N. W. FOURTH ST. STE 500
City, staMENWILLE,IN 47708 Telephone Number E -mail
E:SELLER `GRANTORS ✓:; w° _ ... =-
PATRICK M SEISING
CATHY A. REISING
Selferl-,Y asappearnan conveyance oau ent
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Seller2 - Nam eosappearsanconveyanredotument
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Addr (Nutf�rand Street
Add u erand Street
E -mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
aV, complete asy�required by law, and is prepared in accordance with =1.1- .5, " eal Prop ales Disclosure Act ".
Si nature of Seller of el /re
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Prin , ameo Seller Si n Dare XM /D rated Name Seller Si n Dare XM OD
UYERS GRANTEES
"- APPLICAT( N TOR ,PROPERTY TAX DEDUCTIONS- IDENTIFY ALL °ITEMS THAT APPLY'- - -
JaCO r
er I - Name as appears on c nvayance document
Buyer 2 Name as appears on conveyance document
y�' mberond SPttt%
Email
Telephone Number Email
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS .IDENTIFY AL SE THATAPPLY.
STS NO CONDITION YES NOO CONDITION
❑ 1. Will this property be the buyer's primary
❑ 3. Homestead
residence? Provide complete address of primary
eating /Cooling System
/�� ^ residenf�,incl m county:
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❑ [D 5. Wind Power Device
WSJY S ( O �� -
❑ d 6. Hydroelectric Power Device
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❑ [D' 7. Geothermal Energy Heating /Cooling Device
City, State ZIP Code Counry
❑ 2. Does the buyer have a homestead in Indiana to be
❑ / $. Is this property a residential rental property?
lljr�u
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.
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te Nagt av liable in all counties
r/`�' � /�
Address (Number and Street)
City,Smte ZIPCode County
Pn'mary property owner ronmc[ 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.)
ignpmre ofB erI Signature ofBuyer2/Spouse
Jacob Andrea.) Dolan 8 -ZO ��
Last5digitsofBuy'erl Driver's State Last 5 Digits of Social Security Number Lost 5 digits of Buyer 2 1Spouse Driver's State Last 5 Digits ofsocial Security
License /ID /Other Number Number License /ID10ther Number