HomeMy WebLinkAboutHomestead_Oxby INDIANA SALES DISCLOSURE FORM SDF ID: - Page 2
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CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE. IN 47715 812-402-4553 CHRISTINA(dREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
E SEMIER(S)/GRKINTOR(S) r-s--.T - °—; - —=7 - _ ,4.'..- -- —7— .T;> -
-Erin Michelle Kelsey
Sel rI-Name as rs an conveyance cument Seller 2-Name as appears on conveyance document
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ddress(Numbber and Street) Address(Number and StrerQ
A;ITI ,�=111 1171001
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an omplete as re uired by la and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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t-S iat Ins ofSt:a Signature of Seller
Frin Michelle KPIsev la_3,III
Printed Name of Seller (Sian Date(MM/DD/YYY17J Printed Name of Seller Sian Date(M.M/DD/YYYIT
(F.uxERNT/GR'ANTEE(S)' AP-P,G1GATlON:EORTROPERTYTAX•DEDUCTIONST�-IDENEIE A$L.1TESITHATAPPLY_ - a
-John Oxby
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on conveyance ent
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.l$dress(Num6erand5tre`et)-' Address(Number and Street) '1 D
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL Up OSE PPLY.
t ❑ 1.Will this property be the buyer's primary Y8." ❑' 3-Home te�addSON CAu�TYAUpIT pp
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ igi
433 S Soling St 5.Wind Power Device
Address(Number and Street) ❑ ig 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ si 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El ig
❑ ❑ 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 ❑ 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 Doll counties.)
Address(Number and Street) I 7
City,State ZIP Cade County
2L,-l/ - J Q -�ioa co /- 6 /l D a
Primary property owner contact name E-mail