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HomeMy WebLinkAboutHomestead_Bates (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 b:,PREPARER! "r.. -}- y .<_. ; I Laura Rininyer Closing Coordinator Preparer of the Sales Disclosure Farm Title 7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC Address(Number and Street) Company Evansville, IN 47715 812-759-5555 City,State.and ZIP Code Telephone Number Email E.SELLER(S)/.GRANTOR(S)__ i --- -- --_—�_ _ ____) Dean C Theising v4 Crystal D Theising Seller 1'Narne as appears on conveyance document Seller 2-Name as appears on conveyance document 4333 Bell Rd Apt 1413 4333 Bell Rd Apt 1419 Address(Number and Street) Address(Number and Street) Newburgh IN 47630 Newburgh IN 47630 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 IC 6-1.1-5.5,"Deal Property Sales Disclosure Act". Signature of Seller' ! Signature of S ler Penn C Theising I Djp9J I Crystal D. Theising JO f(�l j Printed Name of Seller Skin Date fM /DD/1TM Printed Name of Seller Sian date(M /DD/YTI) iF. BUYER(S)/GRANTEE(S),=APPLICATION:FOR'PROPERTYTAX:DEDUCTIONS IDENTIFYALITITEMS_THAT_APPLY_' - -_. .] John M, Bates Buyer l-Name as appears on conveyance document Buyer 2•Name as appears on conveyance air, 9921 Address s((Number S 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 OFTHoary, - *Y.L'.,' .. . YES NO CONDITION I YES NO CONDITION V/ Ty „ e 0 ❑ 1•Will this property be the buyer's primary 12 ❑ 3.Homestead UpiTOR residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System residence,including county: ❑ S.Wind Power Device 701 E Sinclair St Address(Number and Street) ❑ Igi 6. Hydroelectric Power Device Ft. Branch, IN 47648 Gibson 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ NI 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. 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) �� ��� 2e. i — ?-00 —do0 a City,State ZIP Code County - 9 Prima,