HomeMy WebLinkAboutHomestead_Brown (2) INDIANA SALES DISCLOSURE FORM SDP ID: Page 2
D:PREPARER- --
_ Ray M. Druley Attorney No.4759-26
Preparer of the Sales Disclosure Form Title
505 N.Church Street,PO Box 146 Law Office of Ray M. Druley
Address(Number and Street) Company
Fort Branch, IN 47648 812-753-4975 druleylaw(ayahoo.com
City,State,and ZIP Code Telephone Number E-mail
,E.SELLER(S)%GRANTOR(S)L— - , - - - - __ . _. -- - - — -- - - - -- - ----- - .. - --
Richard W Barkhurst
Seller)-Name as appears on conveyance d ument Seller 2-Name as appears on conveyance document
30011 �,rnrn p,rf (6VArt
Address(Number and Street) Address(Number and Street)
r �
HaF�9 L-v4ib',6✓11(1t 1 `I7727)
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 I w,and is repared in accordance with IC 6-1.1-53,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Richard W Barkhurst 8/26/2015
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYI)
F,BUYER(S)/GRANTEE(S),-;APPLICATION FOR PROPERTY TAX1)EDUCTIONS IDENTIFY ALL ITEMS THAT APPLY,
Paul F. Brown Delores J. Brown
Buyer I-Name as appears on can veyance document Buyer 2-Name as appears on conveyance document
546 E. State Road 68 546 E. State Road 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOS HATA P A--/
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead otP 2 4 2015
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heatin Cooling System
residence,including county: ❑ Q S.Wind Power Devi
546E State Road Street)68 ��,tlr F�{ILkTY AUDITOR
Address(Number and StreeQ ❑ � 6.Hydroelect�t T �
Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State Z1PCode County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 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)
a -as-oI-JO 1-1900 .31 (1-009
City,State ZIP Code County
Primary property owner contact name E-mail