HomeMy WebLinkAboutHomestead_Elliott INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER.
CHRISTINA LENFERS CLOSING AGENT
Preparer of the Sales Disclosure Form Title
501 MAIN ST STE 101 BOSSE TITLE CO
Address(Number and Street) Company
EVANSVILLE IN 47708 (812)421-4000
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTER(S)
ANDREW I FE ANDERSON
'er I- amen pears opcorJveyance a menu Seller2-Name as appears on conveyance document
ress(NNuTheeerraamilfineet) ch y 1 r t 7( 9 Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and mplete as re d b�%,a prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller / Signature of Seller
L •: L 1. I : •L II' • I -
PrimedNameaf5elfer Sign Date CMM/DD/YYYYJ Printed Name ofSeller , Sun :•te IM/DDAThl
F.BUYER(S)/GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE T II LI . ' ,
SARA E. ELLIIOTT�
Yauascappw n conveyance document Buyer 2-Name as appears on conveyance docutninp
CF 1 8 1 Q 2015
651 S CONCORD DR J
Address(Number and Street) Address(Number and Street)
PRINCETON IN 47670 M., nail 07/701
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
Y NO CONDITION
ES N Y 'iBFF16
❑ 1.Will this property be the buyer's primary ❑� / 3.Homestead
residence? Provide complete address of primary U L�J 4.Solar Energy Heating/Cooling System
res tierce,' chiding nty: ❑ 5.Wind Power Device
boys n
Ad s(Nu er Ch .51V andStreet) ❑ 6.Hydroelectric Power Device
arIv (4761 & G(w a ❑ d 7.Geothermal Energy Heating/Cooling Device
City,State Z Code County
El 2.Does the buyer have a homestead in Indiana to be ❑ B.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. PI-. - .. ', + ctions for more information.
Not available in all counties.)
Address(Number and Street)
162 '-19-19 —ia.1 -000. 007 - O
City,State ZIP Code County ail
Primary property owner contact name
•