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HomeMy WebLinkAboutHomestead_GoodmanSDFID: PrepareraJthe Sa/es Disdomre Form � Addres(NUm6eranCSVeetJ �TAL T(TLE SERV!CES. LLC 19 N W F9UqT� c; �TE 500 Ciry,Smte,andZlPCade EVANSVILLE. IN 47708 JFRRY L SIMPSON Seller ]-,Vame as apyears on romnnnre davmen[ �'�l.1� S �pa G/ ddres (YUm6er and SmeetJ 1(AiYn C fi �iP � n� lj G�o�'/� Title co����y. Te/ephone,YUm6er E-nall ._ "- - . �. . .. _c i.- .�:i' .., _ ANITA M SIMPSON Se er 2- Name as appears on mm�eynnce dau . ent v� 8' S 70o v�% Addr¢s(Numberana$treec) � ����„) G�vP.nSUr/(e, / o Ciry, Smte, � Under penalties of perjury, 1 hereby certify [ha[ this Sales Disclosure, to [he best of my knowledge and belief, is true, correct and co�plete as required by Iaw, and is prepared in accordance with 1�'.6-].1-5.5, "Real Property Sa�es Disclosure Ac[". i, �i � rr CHRIS J. GOODMAN Buyer]-Nameasappevrsono rvantedoc�men[ ��05 5 �5� � Address (Number and Stree[J (�w?l1Gt>>,IC . TtJ �'I��S % � IUCTIONS=.IDENTIFY�ALLiTEh9STHAT.APPCY,i':." "+- t'. , %` TRICIA E. GOODMAN B ��er 2� Name as appears on aonvevanre daumen[ �� S � �1 Addrus(NumberondStreeQ Smte. md21P THE S,1LE5 DISCLOSURE FORM MAl' BE USED TO APPLI' FOR CERTAIN DEDUCf I0�5 FOR THIS PROPERTI'. IDE�TIFI',�LL OF THOSE THAT.IPPLS'. � ❑ 1. 6Vill this property be the buyer's primary � residence? Provide complete address of primary //�� e side��l� clud�p�counry: — 1 ress(�1'umberandS q J - / 7 � �jJ /�� ,� / /� /V d �/� Ciry,Smre lode Counn � 2. Does the buyer have a homestead in Indiana to be vaca[ed for this residence? Ifyes, provide complete address of residence being vacated, induding wunq�: :!ddres (M1'um6er ond Suret) Ciry.Sm[e ZIP Code Counry 3. ing/Cooling Sys�em � /� 5. Wind Power Device ❑ � 6. Hydroelectric Power Device ❑ �7. Geothermal Energy Heating/Cooling Device � � Is this property a residen[ial ren[al proper[y? ❑ �. Would you like to receive tax statements for this property via e-mail? (Provide conmct informotion below. Please see instructions�or more informatian. Not availa6/e in all counties.) o��-l0 3(o-4b0-ool.gaS-oal vdm�..� �m�wrm ��.•mr mnrare name E-mail Under penalties of perjury. 1 hereby certify that this Sales Disclosure, to [he best of my knowledge and belief, is [rue, correct and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (No[e: Spouse informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is b ' filed. v� ) ri-� /%II�A � ,%Vv�fZi��/ �$ignamren/ � eA �namr¢o/BUVer2/Spouse /l n .T .v�J a2 %( Tri��i�FllEn �o�vtma� �1�22�!'1 PnntedLegalNameoJBuyerl Si,gnDale(u.r/00/�»j � Las[SdigitsojBuyerlOriver's Stote Las[iDigitsa%Socfal5ecuriry�VUmber LattSdigiLSOfBuyer?/SpouseDriver's Smte Las[SDigi[sof5ocia15ecunry License/ID/OtherNumber Number Litonse/ID/OthenYUmber