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HomeMy WebLinkAboutHomestead_Shoultz (2) INDIANA SALES DISCLOSURE FORM SDF ID 500 ID 1809922 Page 2 D. PREPARER Bryceann Cutsinger Preparer of the Sales Disclosure Form Title 226 W. Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton, IN 47670- 812-386-1687 samantha.bti @mw.hvcbc.com • City State.and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Rodney J.Garrison Lori A.Garrison .Seller I-Name a appear.on conveyance document Seller 2-Name as appears an conveyance document 5930 W.Countryside Dr. 5930 W.Countryside Dr. Address(Number and Street) Address(Number and Street) New Palestine, IN 46163- New Palestine,IN 46163- Under pet.hies of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co• p -t- as tied by law,and is prepared in accordance Zvi IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature a Seiler Signature of Selig- k...,0 I-. '. Garr,So.,--. LI1 ` tt --- P.i,.and knn.+n/koPpr chin lNSraarnnn-n'n Prl frel!'woo nrColla. Gin D:mo •r•nnmv F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY C Samantha Shoultz Buyer I Name os appears on conveyance document Buyer Name as appears an conveyance document n ;pine E. tee FILED Address/S'ember and Sr{wQ Address(Number and Street) DAt�U4A) )) C�L/ / C:Z, 1 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE Ti TAPPLY. YES NO CONDITION YES NO CONDITION © ❑ L Will this property he the buyer's primary © n 3. Homest�a(��t$SON COUNTY AUDITOR residence? Provide complete address of primary n © 4.Solar Energy Heating/Cooling System residence, including county: n n 821 N.MAIN ST. 5.Wind Power Device Address(Number and Street) n © 6. Hydroelectric Power Device Oakland City,IN 47660 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIPCode County ❑ 0 2. Does the buyer have a homestead in Indiana to be ❑ © $ Is this property a residential rental property? vacated for this residence? If yes,provide ❑ © 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. Not available in all counties.) //^�� Address(Number and SUeet) / - 11-1— I _ n 0 I _ 00b[� t( // g_DO? City.State ZIP Code County Ili_ /VV` UU '1/l//moo Primary property owner contact name Enroll