HomeMy WebLinkAboutHomestead_Owens (9) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Q}'N,N Ire tic, Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main St. Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000
City,State and ZIPCode Telephone Number E-mail
E..SELLER(S)/GRANTOR(S) : '
Gail A Hettenhach
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
' 5z $9 11. 7-?.5 8
A dress(Number and Street), (Number and Street)
• PA-ro r f a 47 G 6
Under penalti• of •erjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and pie • :s/qu' ed,.y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
in
Si/Attar•of Seller Signature of Seller
Gail A Hettenbarh 003/2,3/ 2.NS
Printed Name of Seller !!! an Date(AIM/DP/YY1T} Printed Name of Seller Sion Dote(MM/DD/YYYY)
F..BUYER(S)/GRANTEE(S)=.APPLiCATION FOR-PROPERTY TAX DEDUCTIONS-IDENTIFY ALL EflU'ApP1.5 _f_ :Michael R. Owens 4411--fit/. Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on cony ce
Lob C geduitiky D r.
l)CT 1 2015
Address(Number and Street) Address(Number and Street)
Prl( L;,I4vr.. ) 1.i4 4e7(,7 0
THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ ri 4.Solar Energy Heating/Cooling System
residence,including county: ❑
602 Kennedy Dr 5.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Princeton , IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
❑City State IP Code County
2. Does the buyer have a homestead in Indiana to be ❑ 12 B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 12 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) /�/� _^) (^��/
City,State ZIP Code County St c) — la-Vg 0O� V`". lag-CM.
Primary property owner contact name E-mail