HomeMy WebLinkAboutHomestead_Harvey (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
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
IE.SELLER(S)/GRANTOR(S)' • • ,- . _ - -. . -.,4,-...._.,_:.". s.>22...t ' ..
Stephen J Kleeman
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
308 S Eastview St
Address(Number and Street) Address(Number and Street)
Ft Branch IN 47648
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 law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�atu Iler Signature of Seller
Stephen.I Kleeman /a-/0 /J/
Printed Name of Seller Sign Date(MM/DO/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
IF:BUYERS GRANTEE(S),..APPLICATION FOR PROPERTY--TAX.DEDUCTIONS-.IDENTIFY ALL IT t, T; • I •PP 9 ' I
Mich.- D. . - c MI •
. ' I
:u y e r • . - . ... n on conveyance document Buyer 2-Name as appears on mnveya - •acu - -
201 E Wililams
Address(Number and Street) Address(Number and Street) JUN 12 2015
Ft. Branch. IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YE£ un raNnITION
12 ❑ 1.Will this property be the buyer's primary (—T ❑ 3. Homestead
residence? Provide complete address of primary ❑ TA 4.Solar Energy Heating/Cooling System
residence,including county: ❑
308 S Eastview Dr 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Ft. Branch, IN 47648 Gibson ❑ TA 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 2. Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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.
Address(Number and Street) (7 - o 6
A / /`T-/9 -/o.1. - OOO 3
City.State ZIP Code Cou •
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