HomeMy WebLinkAboutHomestead_Gonyer• INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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Karen Harbison VP
�Preporer oJrhe Sale D'adosure Form Title
803 E State Rd 68 Elberfeld State Bank
Address (Numberand Srreet) Comyany
Haubsiadt.IN 47639
E-mail
:"E>SEL'L•ER S' GRANTOR S �_ � : =f {�t e�T �?�'���_ ��`� .rx� � - _�_;
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Selfer ]- Name as appears om m�veyanre documenc Seller 2� Name as appears on ronveyance documm[
Q551 Winyard Place
Address (Number and Streel) Address (NUm6er and Svee[J _
OwPncvilla IN 47665
Ciry, Smre, andZlPCode Ciry, Sm[q andZlPCOde
E�mail Tele haneNvmber E-mail
Under pena�[ies of jury, 1 hereby certify [hat [his Sales Disclosure, to [he best of my knowledge and belief, is true, correc[
and co . e as r qu ed b urawd.if prepared in accordance wi[h IC 64.1-S.S, "Real Proper[y Sales Disclosure Act".
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Signa 1 r Signo[vreo(Seller
iPrrra du o�-si-2oi2
Pnn[edNameo(Selle� SiOn�afe MM/00/YY1'Y� Pnn[edNamea SellGr Si n0a[e MM/OD/YYYY�
�_F. 5 -APP.LICATION�EOR?�.PROPERTY�TAXDEDUC-T � =�IDENTIF_Y-AICITEMS4THATAP,P�Y¢ - - - .'-` I
Todd W Gon er
E-moil
THH SAlES DISCLOSURE FORM 1fAY BE USED TO APPLY POR CERTAIN DHUUCf10N5 FOR THIS PROPERTI'. IDEYTIFV dLL OF THOSE THAT APPLY.
YFS RO COSDITION I 1'FS YO COBDITION
0 ❑ 1. Will this property be the buyer's primary � ❑ 3. Homestead
residence? Provide mmplete address of primary � Q 4. Solar Energy Heating/Cooling System
residence, including munty: � Q 5. 4Vind Po�ver Device
Q�37 Winyard Place � � 6. Hydroelectric Power Device
Addrut (NUmber and Street)
Owensville IN 47665 Giqson � � 7. Geothermal Energy Heatlng/Cooling Device
CiN, Srate Z!P Cade Counry
[JI ❑ 2. Does the buyer have a homestead in Indiana to be � � 8� �s this proper[y a residential rental property?
vaca[ed for this residence? If yes, provide ❑ � 9. Would you like to receive tar statements for this
complete address of residence being vacated, property via e-maii? (Provide contac[ in(ormation
induding county: below. Please see instruc[ions�or more information.
1082 S Old State Rd 65 Not ovailable in oll counties.)^
Address(Num6erandSUee[) .n� -%i � O�
Princeton IN 47670 Gibson � r�.� - 0 9 ac� �«� �
Ciry.Sm[eZIPCade Counry
PnmarypmPertyownerconco¢name E-mail
Under penal[ies of perjury, 1 hereby certify [ha[ 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-S.S, "Real Property Sales Disclosure Ac[". (Note:
Spouse information, Social Security and Driver's License/Other