HomeMy WebLinkAboutHomestead_Lintzenich INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
)).PREPARER r --w,. 7 -7— -- - t•. 1_
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville,IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail
3 SEL'LER(S)'/,GRANTOR(S)i"". 7%. I` .,___ ,..•:-i Ti, _ :1/4 • -. _ 1
Donald A House Mariette R House
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
207 F 780 S 207 F 780 S
Address(Number and Street) Address(Number and Street)
Ft.Branch IN 47648 Ft Branch IN
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Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and omplete as requi ed by law,and is prepared in accordance with IC 6-1.1-5.5,"Ryal Property Sales Disclosure Act".
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Signature of Seller SI�amre of Seller
innate HHouse 5j L 1 115 Mariette R House 51 Z-1 I
Name 15
Printed Name o(Seller Sian Date WV/DD/YYYY) Printed Name of Seller Sian Date ix14/DD/YYY11
F BUYER(S)°/GRANTEE(Sfa,APPI:ICATIONF,OR.P,kO P,ERTYTAX<'.DEDUCTIONSLLIDENTIFYALL,ITEMS:THA '`Y i - •_ _-J
Steven L. Lintzenich Kenl- . Lintzenich ' l .�*
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on conveyance dac •nt - ' -
205 N 2nd St. 205 N 2nd St.
Address(Number and Street) Address(Number and Street) MAY 2 9:2015
Owensville, IN 47665 Owensville. IN
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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
0 ❑ 1.Will this property be the buyer's primary F ❑ 3. Homestead
residence? Provide complete address of primary ❑ Fl 4. Solar Energy Heating/Cooling System
residence,including county: ❑ F 5.Wind Power Device
207 E 780 S
Address(Number and Street) ❑ SI 6. Hydroelectric Power Device
Ft. Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
[l ® 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ NI 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.
07U AL s-ec-oy a' ,S/rPe ( • Not available in all counties.)
Address(Number and Street)
owemfv/ !e /N If7 US (1100`f1 - '46-I - 9 ao3 -60I.(91.13 -006
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City,State ZIP Code County
Primary property owner contact name E-
Number