HomeMy WebLinkAboutHomestead_Burton 'JDIANA SALES DISCLOSURE FORM SOF ID: rage 2
';PREPARER� -e-�_-�_-��i � �—: "�'`� �Snar"` ealn7-eti x- --e '` R �- SP=�, .ja-r
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eacle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
CV,State,and ZIP Code telephone Number E-mail
Frank J.Sierra Carol S Sierra
Seller I-Name as appears on conveyance document Seller 2•Name as appears on conveyance document
5654 S Sycamore St 5654 S Sycamore St
Address(Number and Street) Address(Number and Street)
Littleton.
)nder penalties of perjury,I hereby certify that this Sales Disclosure,to the best o y\kno edge and belief,is true,correct
`nd complet• as re'uired ('law,and is prepared in accordance with IC 6-1.1-5.5, RealIP operty,Qales Disclosure Act".
1 .-L ,_ C, i Gkp ;���
/onetime of eller S! re of Seller
- - . 0. Carol S. Sierra a I
Printed Name of Seller - Sign '•te( M/DD/YYYY) Printed Name af Seller S(qn sate N DO/YYYY)
r4BUYER(S)/GRAw EqS) APPLICATIQNMbf2 P-ROPERTYSCEDUGTIONS IDENTIFY AEI EMS THAT APPLY{ W_"` -;
Casey D. Burton
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyance document
2245 Greenbriar Dr.
Address(Number and Street) Address(Number and Street)
Henderson.KY 42420
HE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THA -IL
YES NO CONDITION YES NO CONDITION Alb.
12 ❑ 1.Will this property be the buyer's primary ig, ❑ 3.Homestead 1"
residence? Provide complete address of primary ❑ 5 4.Solar Energy Heatingf li2�.Svstim
residence,including county: ❑ 0 CUU 6
5.Wind Power Device
112 N Vine St
Address(Number and Street) ❑ 5 6.Hydroelectric/30w- ti _i
Haubstadt, IN 47639 Gibson ales ;Ili,
City,State ZIP Code County ❑ 7.Geothermal Ener l=.1 t t: �K.qq. - g Device
❑ NI 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential renta�Tdf�I ty?
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)
6- I9- 31- 3ol-born s ►1-bOi
City,State ZIP Code County
Primary property owner contact name E-mail