HomeMy WebLinkAboutHomestead_Parker (3) INDIANA SALES DISCLOSURE FORM SDF ID: 2015 Page 2
D. PREPARER
Kathy Masterson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 kathy@swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
James T. Czoer dba Czoer Construction
Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
650 E 1025 S
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 ,
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct
and)complete,4s require by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
j
.' Signature of Sel r Signature of Seller
*JaM., I-e:7,/,f L"krn LZf r W
11.>I iut.P" 8/19/2015 8/19/2015
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Danny Ray Parker, Jr. Ashley Jeane Parker
Buyer I -Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
215 N Boehne Camp Rd 215 N Boehne Camp Rd A
Address(Number and Street) Address(Number and Street) .�y A
Evansville, IN 47712 Evansville, IN 47712 1
�`•THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFre4 0: i•• •SE THAT�I
YES NO CONDITION YES NO CONDITION 04,- '.t
0 ❑ 1. Will this property be the buyer's primary ISc ❑ 3. Homestead /. e..11j��,
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling Sygtee
residence, including county: 0
❑ 0 5. Wind Power Device Yl0
1285'Al Chukar HOIw ___ R
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.) n /
Address(Number and Street) z/ p coo?. p /I��/
Old City, State ZIP Code County Primary property owner contact name E-mail