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HomeMy WebLinkAboutHomestead_Woehler (2) • INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2 D. PREPARER • Kathy Masterson Escrow Officer ?taperer of the Sates Disclosure Form Title 605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title Address(Number and Street) Company Evansville, Indiana 47713 (812) 425-0055 kathy@swinland.com City State, and ZIP Code Telephone Number E-mail E. SELLER(S)I GRANTOR(S) Melvin J. Bittner Living Trust Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document 503 W Elml St Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 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 Act". Signature of Seller Signature of Seller Printed Name of Seller Sign Date(AMA1/DD/YYYY) Printed Name of Seller. Sign Date(MA1/DD/YYYY) F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY Buyer 1 Name as appears on conveyance document Buyer 2-Name as appeals on conveyance document 107 S Eileen St 107 S Eileen St Address(Number and Street) Address(Number and Street)• Haubstadt, IN 47639 FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIF ALL T{tl�E ThAy • Et YES YEE,SS NO CONDITION YES NO CONDITION 9e 1 ❑ 1. 11411 this property be the buyers primary ❑ 3. Homestead APR 0 1 2016 ( " residence? Provide complete address of primary residence, including county: ❑ 0 4. Solar Energy Heating/Cooling System 503 W Elm SL ❑ 0 5. Wind Power Device • Address(Number and Street) ❑ 0 6. Hydroelectric Yl NTY'AUDITOR Haubstadt, IN 47639 -1 ❑ Gibson 0 7. Geothermal Energy Heating/Cooling Device City. State ZIP Code County ❑ 0 8. Is this property a residential rental property? ❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this vacated for this residence? If yes, provide complete property via-email? (Provide contact information address of residence being vacated, including county: below Please see instructions for more information. Not available in all counties.) Address(Number and Street) a(o— I ?-310-14011 -eeo (3C8- i City, State ZIP Code County Primary property owner contact name E-mail