HomeMy WebLinkAboutHomestead_Mischler 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)
Clinton J. Campbell Megan M. Campbell
Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2990 W SR 68 2990 W SR 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 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 col? teas required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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71 /7u 1 V/�,l tM VIA a e vvi4�1�.(iU
Siihature of Seller Signati-e of!Seller
Clinton J. Campbell 5/7/2015 Megan M. Campbell 5/7/2015
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. : . - -•- • EE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM THWT'�CPPLt, f,'
Zachary W. Mischler Vanessa M. Kern 1) p Ate/ J(�.{.'
• ••- . .'pears on conveyance document Buyer 2-Name as appears on conveyance document
135 N Boehne Camp Rd 135 N Boehne Camp Rd MAY 8 2015
Address(Number and Street) Address(Number and Street)
Evansville, IN 47712 Evansville, IN 47712
•
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION a"`""""` J
0 ❑ 1. Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ s . , - - • g/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
3055 W 1050 S
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 I Gibson' CI 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ A�' 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
/` vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Address(Number and Street)
A4 r d t-o3-/00 -00o , z.3/-0 AY
City, State ZIP Code
County - ma .roperty owner contact name r ad