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HomeMy WebLinkAboutHomestead_Unfried INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER- KAREN HARBISON VP Preparer of the Sales Disclosure Form Tide 803 E STATE HWY 68 HAUBSTADT STATE BANK Address(Number and Street) Company HAUBSTADT IN 47639 812-768-5800 kharbison(Tesbanc.com City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTORJS) ___.-.:.;•` . �— ";.. .-' DANIEL R ANDERSON Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 6077 S S00 F Address(Number and Street) Address(Number and Street) FORT BRANCH IN 47648 U der penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct I corn�•s' a e t fired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 1' ` t r :.ti Signature of Seller Signature of Seller DANIEL R ANDERSON 09/25/2015 Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller t t• ,VOD/YYYn F.BUYEROGRANT`EE(S)-APPLICATION:FOR PROPERTY-TAX DEDUCTIONS {DENT[EYAI1:iITE T P(?L ,_ I®•`.__ _-__• (SLEY J UNFRIELt l LAUREN J UNFRIED o..., i-name ua u,.,...,.<.., nveyance document Buyer 2•Name as appears on conveyance daurrJeptP 2 8 2015 802 E WALNUT ST 803 E WALNUT ST CC Address(Number and Street) Address(Number and Street) n FORT BRANCH. IN 47648 FORT BRANCH,IN 47648 _ TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES cnsn'T nN 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary 4.Solar Energy Heating/Cooling System residence,including county: ❑ ig Wind 703 F LOCUST ST 5.W nd Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device FORT BRANCH. IN 47648 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be II] 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this complete address of residence being vacated, prope via e-mail? Provide contact information including county: se ow.Please see instructions o . • 'n ormation. Not available in all counties.) Address(Number and Street) 1 6 - /9 /8 - Soy -000. 60 y-oxL Cite State ZIP Code Coakry _ \� Primary property owner contact name E-mail