HomeMy WebLinkAboutHomestead_May (11) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D. PREPARER--- <_•-- - `s'
Christina Ferguson 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 ZIP Code Telephone Number E-mail
flatten K Shanks I isa F Shanks
Seller I-Name as op on conveyance document Seller 2-Name as appears on conveyance document
/29 6.Ai 4..,/)8E 4 (/[/ice/ •
/ pi1y, cr r (Number and Street) /
dress(Number and Street)
_7 7639 A
Under penalti�rjury, hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
omplete as re red an prepared in accordance with IC 6-1.1.5.5,"Re 1 Props Sales Disclosure Act".
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�° fl/IL�T /o- q-/..5
,gnature of Seller Sig atur (Seller
Darren K Shanks 10/09/2015 I isa E Shanks 10/09/2015
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(M.N/DD/YYFY)
F:BUYERS)/GRANTEE(S)_-`APPLICATION FOR PRUPERq'Y TAX•DEDUCTIONS.=IDENTIFYALL ITEMS THAT APPLY. , . _ _____ - 1
Kendra L.
on conveyance document Buyer 2-Name as appears on conveyance document
1001 Adam Ct.
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 %f f
/
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TAPPLY I�ZO1
YES NO CONDITION YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary S ❑ 3. Homestead CGei e -4-
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling,
106 N Campbell Oh
residence,
ampbresidence,including county: ❑ 5.Wind Power Device 0,T?R
Address(Number and Street) n igi 6. Hydroelectric Power Device
Haubstadt, IN 47639 Gibson
Q 7.Geothermal Energy Heating/Cooling Device
❑City State Z P Code County
2. Does the buyer have a homestead in Indiana to be ❑ IN R. 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, 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)
r
City State ZIP Code County
n-47- - a 3- Oda. *2-oa f
Primary property owner contact name E-mail