HomeMy WebLinkAboutHomestead_Rosa INDIANA SALES DISCLOSURE FORM SDF ID: . Page 2
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Bryceann Cutsirmer
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.bti(@mw.twcbc.cem
Ciy.State,and ZIP Code Telephone Number E-mail
-E.SELEEk(S)ZGRAINTEOR(Siti:.:t.:."i irri., .1''Lit.-.2■FiS-=7-42:,--)ECC.5-7(;1117.A- 7:7-i±Fr.■:::217:7-=lilt- -: :';:it:52•7,f;i--:iii:n
Thomas W Mason
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
9327E 125 S
Address(Number and Street) Address(Number and Street)
Oakland City IN 47660
Under penalties of perjury,thereby 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".
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Signature of Seller
54(a/(0 Signature of Seller
Thomas W Mason
_Printed Na _ _,,_ ,.. , _..._ , _ __ _.__Sion Date DOWD/MY) Printed Name of Seller Sian Date DOWD/MY)
farER(5)/GRANTEE( )kAPPLICATION,FORIPROPERTY,TAX DEDUCTIONS,i-IDENTIFYIALLIITEMS:FHAT: Pli31`1,:,_ .1__ •7 d ' __.;
Vanessa Rosa
Buyer I-Naillairgirrrcedocument Buyer 2-Name as appears on conveyance documen
.Tenth St. LP
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 4141-*
THE SALES DISCLOSURE FORM MAY HE USED TO APP LY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT trPat5,
lilt
YES NO CONDITION . k
^10 0/
l71 0 1.Will this property be the buyer's primary (7) 0 3.Homestead
2'
0
residence? Provide complete address of pri i • is 0 Ig , -Solar • :• eating/Cooling Systene
residence,including county:
D 14 5.Wind Power Device
127 S Madison St
Address(Number and Street) 0 (7] 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson El 2 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
D MI 8.Is this property a residential rental property?
0 2.Does the buyer have a homestead in Indiana to be
RI
vacated for this residence? If yes,provide D 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.
Not available in all counties.)
Address(Number and Street)
A - g- jo7-CO/d 50'?-a?
City,State ZIP Code County
Primary property owner contact name E-mail