HomeMy WebLinkAboutHomestead_Jost (5) INDIANA SALES DISCLOSURE FOCNq SDF ID: •
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jt P - a , A. Peters '— - '.dS, S *;.,.yr :-'G "'ii�
1 A.Peters
iwpai t of Sala Disclosure Farm
5515 E. Virginia Street nl"
i1 Law Offices of Steven K. Deig, LLC
Maims(Number a.:d Scrret)
1 Evansville, IN 47715 (612)47�2)477-5577 zacb @deialaw.com
O:c.Store,and ZIP Cede
71.1epbas Number
E rncil
•' SELLIER(SYLGRANTOIi(Sl e�r -t r . 1.."11d. - :-'�,_ —,
Jeannie R.Jost 'n ,$7C4Te tTeal
Sellert-Noneas appears on rom'evunce document Seller? Name osa
9344 Lake Haven Dr. ➢pears on cane-quire document
Address(Number and Street) Address )
(�IumberandSarrt
Elberfeld, IN 47613
Ctrs:S:a:c and ZIP Cede
City.Siutc,and ZIP Code
Tel h'am'x: Email Televiewer Number
Emxil
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is trite,correct
an in lete as required y 1 w,and is prepared in accordance with IC 6.1.1.5.5,"Real Property Sales Disclosure Act".
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Buyer I-Name as appears on conveyance document Buyer:'Name as appears on conveyance document
501 E.Plum Street
Address(Number and Street) Address(Number and Street) MAY 25 901fi
Haubstadt, IN 47639
YES NO CONDmON YES NO CONDITION
[✓j ❑ 1.Will this property be the buyer's primary Z ❑ 3.Homestead
residence? Provide complete address of primary ❑ 12 4.Solar Energy Heating/Cooling System
residence,including county:
501 E. Plum Street ❑ ✓'I S.Wind Power Device
eddren tNam - and5aeey ❑ [✓I 6.Hydroelectric Power Device
Haubstadt, N 47639 Gibson
❑ (2 7.Geothermal Energy Heating/Cooling Device
City.Seale ZIP Code C untr
❑ 2 2.Does the buyer have a homestead in Indiana to be ❑ U B.Is this property a residential rental properly?
vacated for this residence? If yes,provide ❑ g 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.
Buyer currently resides at 501 E. Plum St., Haubstadt, IN 47539 Not available in all counties.)
Address(::umber and Street)
�-sl r'�
Opt Rate ZIP Code Caurs o S-3 r- 304 - boo . 5 t-f6-
Primary nroaervo.'ne:centva name Email