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HomeMy WebLinkAboutHomestead_Dixon (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 �1D..P.REP,ARE12 - rZ - • 'a.re-,'-1 zaftst l:.: . --e /...-.. •- ,- _ Stacey Salzman Closer Prepares of the Saks Disclosure Form • Title 4962 Lincoln Ave. First Advantage Title Addrm(Number and Street) Company Evansville, IN 47715 812-490-8485 theteam Tfirstadvantagetitle.com Gry,State,and ZIP Cade Telephone Number E-mail gEt ELLER'(S� RANTOR(S) T`.-SV s.,;�.sbgi <' <• .:y -. -.C. s*,::.:: , - ' L Cd .Mlri N1C1 m ( c( rn� ti? ; � I_ frvkAil Kilts-Name@ co / � � e"d\)ocu t er? amt on conveyance doctim-aid ' (NMI J A d (Number eet Ad dres(Number and Street) , n- ^l_- c Lh G9C f P Under p nalties of perju I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co le s reef Ir by law, is prepared in accordance with IC 6-1.1-5.5,°Real • o 1 -rty Sales Disclosure Act°. re oll6dddler l ••e cture° Seller l l r i , �Cl Ph Cn ((I Lite, 5 ICI I �S� / ► Irk I4 . (fad ,j I4 i Printed Name ofSeller Sign Date(NH/UD Printed Name of Seller Sign Date(NA/DD/nYY) FF, YER(SVMNinsE S)ffAP,EL(e'mal1 TRIPJZOBER(litAxdDED.tf;I NS-AIDENihili ffillu fargilH (l(t'AP,PI�Y,vx=r_.a. ,r:;;. ashes(, (0 DI Xn& ) ko.rrot n . I ) iX I-Name as appears orvonveyance document i 2-Name as oppeog on conveyance document Ad mberan ) LI (� Address(Numberand Street) T- gone\ k. �I �1(o THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCI1ONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES" NO CONDITION --ea g ❑ 1.Will this property be the buyer's primary Er" ❑ 3.Homestead ✓(/N,pp residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Coo 'ng Sys`fem re;id ce,includin c unty: O O Z�/fir 1�'�L) S 1.Ue N Nt ❑ IN 5.Wind Power Devief& 0 • . Ad Number L nett) ❑ 6.Hydroelectric Power Dever 'i 0• c (NQ k, .ON 41b'ikA IN �,.: City,State ZIP Code 1 �� carroty t-""' • ❑ 7-Geothermal Energy Heating/thihe,;e/�e�Ie'v'ice ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental prgrp@;pr? 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. Not available in all counties) Addreu(Number and Street) City,State ZIP Code County c?-i9/1-coo -G0. tai- aa0 Primary property owner contact name E-mail