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Homestead_Murnahan
INDIANA SALES DISCLOSURE FORM SDF ID SDO ID Page 2 D.PREPARER Bryceann Cutsinger Preparer of the Sales Disclosure Form Title 226 W. Broadway Broadway Title,Inc. Address(Number and Street) Company Princeton,IN 47670- 812-386-1687 samantha.bti @mw.hvcbc.com Clot Store,and ZIP Cafe Telephone Number E-mail E.SELLER(S)/GRANTOR(S) Genie M. Martin Jean Koontz Seller I-Name as appears on cancel ice document Seller 2.Name us appears on conveyance dexment 700 ,01/767e-cancel ()AI Vs- 3co 747/4 (/ /e ja / SOS— A.Ares. Number and Sir et) Address(Number and, et 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 law,and is prepared in accordance with LC 6-1.1-5.5,"Real Property Sale II isclosur- Act". J Si 'azure of Seller / n S aloe<-of Seller ' 7 �jPi �e ii? �t(,) -- i, - 4- \ �. rraa/1 / oo �Az \ 7-3D-/s Primed None"(Caller Ginn Pre.1mm/no nvVI Printed Prove 01c Ear Ono nr.r..r,tan nvn F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY I Leah Murnahan Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance document 6781 N.West St. Address(Number and Street) Address(Number and Street) Owensville,IN 47665- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OFTHOSFTT I T 1PLY U 2015 YES NO CONDITION © ❑ 1.Will this property be the buyer's primary © ❑ 3. Homestead ��n['residence? Provide complete address of primary ❑ © 4,Solar Energy itltit J System residence,including county: ❑ © 5.Wind fiblOACIJI,gtQUNTY AUDITOR 511 N.MAIN Address(Number and Street) ❑ © 6.Hydroelectric Power Device Owensville, IN 47665 GIBSON ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 111 0. 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. Please see instructions for more information. Not available in all counties.) Add.+.+LNUrnhvr and SU vet) '�D r"1 -oaa GIBSON a �- , 'l.o,- yoy- 0� r/"'`/ City.Store ZIP Code County Primary property owner contact name E-mail