HomeMy WebLinkAboutHomestead_Goldman (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparer of the Sales 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 teresa @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)I GRANTOR(S)
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Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
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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 re uired by law,and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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\Signs e of Seller t/ Signature of Seller
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Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MMIDD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Christopher S.Goldman
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on convey ce document
1564 E Macada Ct
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 ii, ,i(.7 -)v.._
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. ITIFY OF,THOSE THAI APPLY.
YES NO CONDITION YES NO CONDITION ON r.
0 ❑ 1. Wll this property be the buyers primary 0 ❑ 3. Homestead on
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residence? Provide complete address of primary 0 0 4. Solar Energy HeatinglCoolln6r@,ys m
residence, including county: ,Y
❑ 0 5. Wind Power Device
1564 E Macada Court ❑ 0 6. Hydroelectric Power Device
Address(Number and Street)
Haubstadt, IN 47639 Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ 0 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)
aZ 70,3 -/G- WO - 0 04. `` ,j7 61,t/
City State ZIP Code County Primary property owner contact name 77 E-mail