HomeMy WebLinkAboutHomestead_Nix INDIANA SALES DISCLOSURE FORM SDF ID: 2015 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 teresa @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Drew A. Meny
Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
506 E Haub St
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 ,
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct
and core a�/quuiiirrre�y law,,aan�1 is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
c8ig r of Seller" /- L/ Signature of Seller
Drew A. Meny 5/5/2015 5/5/2015
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Jennifer A. Nix Charles William Nix (1,0111., j_c--ticL=1"ratinoNc:\.l
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on Conveyance document /
6801 Wassmer Rd 6801 Wassmer Rd �41�_Is-senn�-I's_t
Address(Number and Street) Address(Number and Street)
dl ntr-
CO 5('
Poseyville, IN 47633 Poseyville, IN 47633
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY AL E THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyers primary El ❑ 3. Homestead
residence? Provide complete address of primary ❑ El 4. Solar Energy Heating/Cooling Sys
residence, including county: M4
❑ 0 5. Wind Power Device
506 East Haub Street c/Jig
Address(Number and Street) ❑ 8 6. Hydroelectric Power`�-vice
IHaubstadt, IN 47639 Gibson ❑ El 7. Geothermal --c:nt:'�,.� .oh,. Device
City,State ZIP Code County ❑ 0 8. Is this property a residenaal - 7 property?
❑ X 2. Does the buyer have a homestead in Indiana to be ❑ El 9. Would you like to receive tax stat&M& 4or this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence bei vacated, including county: below. Please see instructions for more information.
� J� Not available in all counties.)
Address(Number and Street)
24 i 9-3/-c3av -aro 3 70 co9
City,State ZIP Code County Primary property owner contact name E-mail