HomeMy WebLinkAboutHomestead_Couts INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -- ' - .- _ - . _ - --
Jerry D.Stilwell --- - - - Attorney at Law - -- - - - - -
Preparer of the Sales Disclosure Form Title
302 N.Prince Street Bamberger,Foreman,Oswald 8 Hahn,LLP
Address(Number and Street) Company
Princeton,IN 47670 812-386-6482
City,Slate,and ZIP Code Telephone Number
E-mail
E.SELLERS)/GRANTOR(S) - - -
Michael L.Retina
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
457 E 1200 S
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 complete as required by law,a d is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
f62- �8'lv-ktin fi4u.,R
Signature of Seller I Signature of Seller
MICHAEL L.REXING 9 `i,(1'2,Q1
Printed Name of Seller Sian Date(MM/oo/YYYY) Printed Name of Seller Sian Date(MM/ua(rvrv)
F.BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMSTHATAPPLY_ _ -_
Seth Couts
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance dams nt
tAdr s 565S
Address(Number e4766Street) Address(Number and Street) ��
Ovr,
YES NO CONDITION I YES NO CONDITION llii BSO/y
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead Ll _itit„, q
residence? Provide complete address of primary ❑ IN 4.Solar Energy Heating/Cooling SysterOR
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ IN 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 2.Does the buyer have a homestead in Indiana to be n 0 8 Is this Rroperty a residential rental property?
vacated for this residence? If yes,provide ❑ 0 t9j W you like to receive tax statements for this
complete address of residence being vacated, c\ tK• operty via e-mail?(Provide contact information
including county: below. Please see instructions for more information.
C O Not available in all counties.)
Address(Number and Street) /
City State ZIP Code County ? tie 17-D 9 -/OO CO ! 9/3oa f
Primary property owner contact name E-mail