HomeMy WebLinkAboutHomestead_Bedell INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.;PREPARER - _ . ' J
Laura Rininoer Closina Coordinator
Prepare of the Sales Disclosure.Four. Title
7320 Eaale Crest Blvd Sie 201 Reoional Title Services. LLC
Address(Number and Street) Company
Evansville. IN 47715 312-7595555
ay,State and ZIP Code Telephone Number E-mail
t:a SECLER(S)/GRANTOR(Sl . J
y�'avn? Kinn Heather King
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
a) S0 E- lvlL S . 2"2�c (" F u00
Address((Number and Strcet) t. J 1 / /!7 Address(Number and Street)
F�- D:ail lhl 1AI 77v7a Fr Pi nc'kt IN 's NF—i
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,and is prepared in accordance with IC 6-1.1-5.5,1"/Real Property Sales Disclosure Act".
1
Signu eofSeller Signature n/Seller
Wayne King 07/10/2015 Heather King 07/10/2015
.Printed Name o;Seller Sian Date(HR/DD/111I1 Printed Name of Seller Sian Date U:H/DD/!Yl'I
-F.'BUYER(S)/GR4NTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Dustin P Bedell
Rover I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
Address N 5th er St.
.odd:es(N'umue:and Street) Address(Number and Street)
Terre Haute. IN 47804 ✓�( 4.pb
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THATQp,,��,,Y `,,, �!
t NO CONDITION I YES NO CONDITION 71. #.
n n 1.Will this property he the buyer's primary fl n 3. Homestead AVOiTO
residence? Provide complete address of primary n gi 4.Solar Energy Heating/Cooling System R
residence,including county: n SI
5894 S 102= S.Wind Power Device
Addres-(Number and Street) n ii 6. Hydroelectric Power Device
of Branch. IN 47648 Gibson n SI 7. Geothermal Energy Heating/Cooling Device
City.State .IP Code Count'
n 2. Does the buyer have a homestead in Indiana to be n z 8. Is this property a residential rental properly?
vacated for this residence? If yes,provide n gl 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 Street) G rn ado
Cipt State ZIP Code County
e — /9 O" - aao - COG. 0 7(9- &oG
Primary property owner contact name Email