HomeMy WebLinkAboutHomestead_Shoultz INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - ., t
Bryceann Cutsinoer
Preparer of the Sales Disclosure Form Tide
226 W. Broadway St. Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 samantha.btiemw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
•
E.SELLERS)/GRANTOR(S)'. - ' : - - - . r. - _ ...
Kevin D Soindler Melissa M Spindler
Sellerl-Name as appears on conveyance vmen[ Seller 2-Name as appears on conveyance document
d' � S S . J kill 1�a 17'r 39 -S—B-ra--rd l 0 3 5 Da rnasa A-
Address(Number an Street Address(Number and Street) �1,At q
Haubstadt IN 47639 Haubstadt IN 47639 Y`�1A0ka ybo 3 )
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 "Real Property Sales Disclosure ct".
_241,-*;.:it,8 3-1-4 (pkA$Pick- 3)1 226/1k
Signature of Seller C7, Si afore ofSeler
Kevin Soindler u- ' • Li • 1• - 1 j I 1.11•
Printed Name of Seller Sian Date(MM/Da(rvri) Printed Name of Seller i •1 Pat i11;e Y1Y1'I.
Clint )/GRANTEE(S)=APPLICATION FOR-PROPERTY TAX DEDUCTIONS-.IDENTIFY ALL.ITEM"• H• A'- • 7-ii ! • - .
(/ A. Shoultz ) Brittnie Allen , 1AR 1.0 2016
\—M-rev on conveyance document Buyer 2-Name as appears on conveyance docume
X6965 N. Nixon Rd. 6965 N. Nixon Rd.
• Address(Number and Street) Address(Number and Street)
Hazleton, IN 47640 Hazleton, IN 47640
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YE- M^ ONDETIO.N
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead)
residence? Provide complete address of primary 0 4.Solar Energy Heating/Cooling System
residence,including county:
❑ IA 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.1s 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.
6965 N Nixon Rd. Not availabl- '• • • •
Address(Number and Street)
Hazleton, IN 47640 Gibson 1� a( - 1 4 . 3/ - 3o y -000. 2 7 .5 -00
City,State ZIP Code Covmy�
E-mail