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HomeMy WebLinkAboutHomestead_Turek INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D:,PREPARER, ' = -- � - ' a `. -_ _= • LANA C. HARPER CLOSER Preparer of the Sales Disclosure Form Tide 19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES. LLC Address(Number and Street) Company EVANSVILLE. IN 47708 812-468-8485 City,State,and ZIP Code Telephone Number E-mail ,E:SELLER(2/GRANTOR(S)' - . �, -_ . - - - _ - - - . -. CATHY C MARTIN Seller I-Name as appears n conveyance documen Seller 2.Name as appears on conveyance document 9y-tram N .s-\ T -�\ce res(N(Number and Street Address(Number and Street) Q \,; 11Q , 04.-173..c� Under t enalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an d i p.- • :s requu d by law, . d i . epared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 5 n j re baler a1 - — V" 1✓ Signature of Seller tat Pnned Name of Sell. Sign Date(MMrya Printed Name of Seller �-1 ggg g- te(MM/DD/IYY1] .P..BUYER(S)/G' •NTEE(Si._APPLICATION,EOR!PROPERTYTAXDEDUC-TIONS=IDENTIPYAELJ vt t Tf _ - _ -- TODD TUREK Buyer 1-Name as appears on can ryonce document Buyer 2-Name as appears on conveyance document 32_6 /). f'/mot/ti/ 5"/: SEP 3 2015 Address(N tuber and Street Address(Number and Street) Goa Ga THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YO CONDITION 0 ❑ 1.Will this property be the buyer's primary NI • 3.Homes -.. residence? Provide complete address of primary ❑ 5 4.Solar Energy Heating/Cooling System / residence,indudi younty: ❑ TA S.Wind Power Device Add rethlivumber Fad streeq _ / ❑ 5 6.Hydroelectric Power Device O&h/ Q./7(l / /y 4L770 l.a O Gibson ❑ 5 7.Geothermal Energy Heating/Cooling Device City, rate 7 Code County 2.Does the buyer have a homestead in Indiana to be ❑ 5 8.1s this property a residential rental property? vacated for this residence? If yes, provide El 5 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. ale- ) available in all counties) Address(Number and Street) ^'I_- I (�-_ �-�-ad ay. . Cr)? City,State ZIP Code County t�t� T -col Primary property owner contact name E-mail