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HomeMy WebLinkAboutHomestead_Gilmore 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.corn City,'State,and ZIP Code Telephone Number E-mail E. SELLER(S)/GRANTOR(S) Tommy D Pedersen Velma J Pedersen Seller 7-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1706.Z(iale Smith Rd 1706 Zhale Smith Rd Address(Number and Street) Address(Number and Street) LaGrance KY 40031 La Grange KY 40031 •1.-._;.,Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". Signature of Seller Signature of Seller TominyrD Pedersen Velma J Pedersen Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DDNYYY) F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY Richard D. Gilmore Melissa S. Gilmore Buy&•7 -Name as appears on conveyance document Buyer 2-Name as appears on conveyance document . 117 S.Broadview Circle 117 S Broadview Circle Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton, IN 47670 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDE FY f PLY. YES zc NO CONDITION YES NO CONDITION O `--''O 1. Will this property be the buyer's primary El ❑ 3. Homestead JUN 10 2015 :21 residence, Provide complete address of primary ❑ p 4. Solar Energy HeaiinglCooling S stem residence, including county: ❑ 1 5. .`ljiL�1/_yAtL—Jgf_ttf-�gS.g-- -,- Wind Power De 117 South Broadview Circle Drive ❑ 0 r�I (&rl�dWd-cY AUDITOR Address(Number and Street) 6. Hydroele (Princeton, IN 47670 Gibson ID El 7. Geothermal Energy Heating/Cooling Device • CivState ZIP Code County ❑ El 8. Is this property a residential rental property? ❑ ❑ 2. Does the buyer have a homestead in Indiana to be ❑ El g. Would you like to receive tax statements for this arc -- vacated for this residence? If yes, provide complete property via-email? (Provide contact informatis:1 address of residence being vacated, including county: below. Please see instructions for more in!c:,naiton. `-i Not available in all counties.) Ad&ass(Number and Street) (. ) Ha- 3O 1 ©w1 I , &a 9-098 ,-k; �l a City;State ZIP Code County Primary property owner contact name E-mail