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Homestead_Parmer
INDIANA SALES DISCLOSURE FORM SOF ID SDO ID 1817347 Page 2 ---- Jay D.Walden Attorney at Law Preparer of the Safes Disclosure Form Title 202 E.North Street Law Office of Jay D.Walden Address(Number and Street) Company Grayville,IL 62844- jdw @nwcabie.net City,Swte and ZIP Code Telephone Number E-mail 1E,SE?IiER(S)%611ANTOR(S)I _ --- - --- - — —.—_ Steven B.Gifford Sarah E.Gifford '�_ Seller I-Name as appears on conveyance document Seller 2-Name as a rs on conveyance document 1101 W.State Rd 68 1101 W.State Rd 68 Address(Number and Street) Address(Number and Street) Haubstadt,IN 47639- Haubstadt,IN 47639- City,State and ZIP Code City,State,and ZIP Code E-mail 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,"Re. Proper Sales Disclosure Act". { IL ignature of Seller Sign�o�\ar�eofSeller/ V� '1. S}ee . 3C� c d I�rsJQ(% L , 72y �z'(�� I 0If� On wl Nmm,nFWlor Finn nn r✓ mnMM- or MNmmonrc'n,,, Cinn!WA. u>,,innmfYl (F-BUYERS)%GRANTEE(S)` APPLICATION F,OR;PROPERTYJAX DEDUCTIONS,_IDENTIFY/ACL ITEMS,THATAPPLY,_, . _it__ __ Matthew R.Parmer Amy M.Parmer Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance dote 1003 W.Elm St. 1003 W.Elm St. Address(Number and Street) Address(Number and Stmt) a 4,4(4) . Haubstadt,IN 47639- Haubstadt,IN 47639- City,City,State,and ZIP Code City,State,and ZIP Code 144/ 19?0 f Telephone Number E-mail Tele•hone Number �, E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF TN a S'TOO •St /p • YES NO CONDITION YES NO CONDITION 0(/A/�.}, © ❑ 1 Will this sproperty e the buyer's primary primary © ❑ 3.Homestead AUpirbR ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 1101 W.STATE RD 68 ❑ © 5.Wind Power Device Address(Number and Street) ❑ © 6.Hydroelectric Power Device Haubstadt,IN 47639 GIBSON ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County © ❑ 2.Does the buyer have a homestead in Indiana to be ❑ © 8.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. 1003 W.ELM ST. Not available in all counties.) Address(Number and Street) Haubstadt,IN 47639 GIBSON Z (o. Q.?.0 )../0 a • Q I. 0,5 5 0,7 y City,State ZIP Code County Primary property owner contact name E-mail