HomeMy WebLinkAboutHomestead_SieversINDIANA SALE$ DISCLOSURE FORM SDF ID:
D. PREPARER� - � ' � � � � ' � ' - � �
Brvceann Cutsinaer
Preparer o(lhe Sala D"udarvrc Farm
226 W.Broadwav
Add�ecs /NUm 6s and SveetJ
Princeton.IN 47670
Ciry.Smle, and ZIPCade
E.SELLER(Sl/GRANTOR(Sl �.- � � '_ _ . --- � � '
Seller 1- Name as appevrs an canvryanre dxumwt
�em HaNPy �„
Address (NUmber ond5vttt)
OW .fIGV1IIP IN 47Fi85
Ciry. SmtS and ZIPCode
af8658(alatt.com
rm�
troadwav Title. Inc.
Company
'�72-386-1687
TdephoneNumbe�
. . � : .1:'. � �. . . .. .
Seller I� Name at appeors on ronveyvnce document
wensville IN 47fi
Ciry.Smtg and ZIP Lade
E-mail
Under penal[ies of perjury, I hereby certify [ha[ [his Sales Disclosure, [o the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in atcordance with 1 64.1-5.5, "Real Property Sale Dis losure Ad".
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Signamrea(Sel/er SignaNreo/Seller g '
nl�,. [� F�u� �d 1 Z' 2°�T (;anriarn A Fallc � �� � It ���—�S
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Buyer2-Nameasappearson
Add2ss (NUmber and SveetJ ACLr¢s (NUmberanC S[
Indianaoolis IN 46227 Indianaoolis.IN 46
Ciry, SmtS a�d LPCode Ciry, Smtq and ZIPCode
THE SALFS DISCLOSUitE FORM MAY BE USED TO APPLY FOR CERTAIY DEDUCI'IOYS FOR THIS PROPER7Y. IOENTIFY ALL OF THOSE THAT APPLY.
� ❑ 1. Will [his proper[y be [he buyer's primary (
residence? Provide comple[e address of primary
residence, including county:
704 S Waltrrc St
Addrm (A'um6vand5trmt)
Ft. Branch IN 47648 Gibson
Ciry.SmmLPtode Counry
❑ ❑ 2. Does [he buyer have a homes[ead in Indiana to be
vacated for this residence? [f yes, provide
comple[e address of residence being vaca[ed,
including county:
Address (Numbv and5[rttt)
Ciry. Smre2lPCode Lounry
❑�
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❑ 3. Homestead�
� 4. Solar Energy Heaung/Cooling S�
0 5. Wind Power Device
0 6. Hydroelec[ric Power Device
Q 7. Geo[hermal Energy Heating/Co�
Q 8. Is [his property a residen[ial rer
❑ 9. Would you like to receive tas sL
property via e-mail? (Provide ca
below. Please see instructlons for
Notavailable in all coundes.)
-19-/8 - 303 -aoo
Under penalties of perjury, 1 hereby tertify tha[ [his Sales Disdosure, to the best of my knowledge and I
and tomplete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "Real Property Sales
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Home:
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Pn'ntedLegalNameo Buyerl 5(qnDate NM/00/YYYtj
Las[Sdigi6o/Buyer7Driver's State Las[SDigitro�5ocialSecurityNum6er
License/ID/Other Number
ofB�yer1/Spouse
Last S digitr of Buyer 2/Spouse Onver's
Number Lirense/ID/OtherNum6er
e Device
proper[y?
��enCS for this
�[ in%rmation
re informa[ion.
5 -o
is [rue, correct
sure Ac[". (Note:
)eduttion is
Digi[s oj5acia15ecurity