HomeMy WebLinkAboutHomestead_Barrett (4) INDIANA SALES DISCLOSURE FORM SDF ID: 2015 Page 2
D. PREPARER
Kathy Masterson _ 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 kathy@swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Dan Schoffstall
•_:,Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
12894 S Sunset Dr
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 co plete as required by law, and isDpprrrepared in accordance with IC 6-1.1,5.5, "Real Property Sales Disclosure Act".
ig ature of Seller Signature of Seller
Dan Schoffstall 5/29/2015 5/29/2015
- 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
William J. Barrett Laura E. Williams
-L Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on co anci101 Hull St 101 Hull St ......���ddd ment yb
..Address(Number and Street) Address(Number and Street) 'O/JV�d'
Haubstadt, IN 47639 Haubstadt, IN 47639 JUN
:
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFYALLC" -V-. THAT APPLY.
.YES NO CONDITION YES NO CONDITION AVO/TO�
❑ 1. Will this property be the buyer's primary 0 El 3. Homestead
residence? Provide complete address of primary ❑ EI 4. Solar Energy Heating/Cooling System
residence,including county:
❑ EI 5. Wind Power Device
12894 South Sunset Dr.
Address(Number and Street) ❑ El 6. Hydroelectric Power Device
,Haubstadt, IN 47639 I Gibson' ❑ El 7. Geothermal Energy Heating/Cooling Device
1
F City, State ZIP code County ❑ El 8. Is this property a residential rental property?
❑ 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.
1 U. \ICU` ( 1_ ;F— Not available in all counties.)
Address(Num eer and Street) (f l �/' 1 Z L7� �n�, O' c ^� /yam
-f \ \ tYu J.J �'3A ( 114 t' U- ` L1 L l s 0 r\l Primar4r_ 7ya owner/ntac!nam c Oa / O1.J 19 E-mai
City, State ZIP Code County
•