HomeMy WebLinkAboutHomestead_Cox (2) INDIANA SALES DISCLOSURE FORM SDF II): Page 2
'D.;P,REPARERc'._... .L_721-:.:::::_--.:7-77,.R..;..]_ _ _C _.. _ __-72, -_7t. . __
Preparer of the Sales Disclosure Form Title •ADO Centmcrec Dr. . Sig 110 Ontfvcp Lcne�-tr Set/ce5
Address(Number and Street) Company
2c\k- PA (5275 nib-102-73�5
Cut Srhte.clad ZIP Code Telephone Number E-mail
;E.,SELL•ER(S)rGRANfOR(S);." ,i..1- .- -•-+ - _ - -....
HAROLD L.COLEMAN SHARON L.COLEMAN
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
/iv 5. Jerca, Lane._ WO S T�r ,n5 Lane_
J Address(t\'um er @Kt Street)
Address(Number Street) )b S �- l rU y7(p 39
}10∎01 4-b.n(4- I ti) y 76°3 k ,
/
Under penalties of perjury.I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co I r to as rev . ■ b ,.'/Y1 is pr tared in accordance with I 6-1.1-53."Real Property Sales Disclosure Act".
.tgn•ture((ofSeller 61--., Signature of Se ler
1-10,5-Opp e LoICo,An <65/(L She.roe, L., Co l f/riaA 412.41 it
Printed Name of Seller Sign Date(ALWDD/)'Y)')) Printed Name of Seller Sign Date(aIMIDD'YYY})
F.BUYER(SvGRANTEE(S)=APPLICATION:FOR PROPERT':TAX'DEDUCTIONS'=IDENTIFI';ALL ITEMS THAT'.APPLY.-.-"
TAMMY K.COX
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
110 S.Jeremy Lane __
Address(Number and Street) Address(Number and Street)
nubSta .IN ZIJ9
THE SALES DISCLOSURE FORM MAN'RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR ay P$critW&. IDENTIFY ALL •
OF THOSE THAT APPLY. AM1 1 / LVI
YES NO CONDITION i YES NO CONDITION
in I I I. Will this property be the buyer's primary I>( s 3. Homestead - . 11
residence?Provide complete address of �tl. •p X 4. Solar Ene5Q' a tJU - A ftcerOR
primary residence,including county: ��,�1IRqSSVV
S 5. Wind'Pbwer Pence
Address(Number and Street) I X 6. Hydroelectric Power Device
City.State ZIP Code County I X 7. Geothermal Energy Heating/Cooling Device
- X 8. Is this property a residential rental property?
X I ?- Does the buyer have a homestead in
X 9. Would you like to receive tax statements for
Indiana to e vacated for this residence?If
property yes.provide complete address of this property via e-mail?(Provide contact
residence being vacated.including information below.Please see instructions for
county: more information.Not available in all
counties.)
Address(Number and Street) /� y�
City.State ZIP Code County a IQ 'g-31:,- go3-DDo.l of-Dog
Primary property owner contact name E-mail