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HomeMy WebLinkAboutHomestead_Houchin (3) INDIANA SALES DISCLOSURE FORM SDF ID:_ Page 2 ITICP:REBARER,' 5 -- ,T-r .- . .: a r "d.,' - . a r. Samantha Cutsinger Preparer of the Sales Disclosure Form Title 226 W. Broadway Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 812-386-1687 samantha.btiemw.twcbc.com City,State,and ZIP Code Telephone Number E-mail E>SEL ERMGRANTOR(S) ir_'YLvL _ ;:,13ti - .cx—•t.t- T_tu 4-___a. . .1 . c Daryl R Cook Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 418 W Columbia St Address(Number and Street) Address(Number and Street) - Un. -r . •nal•e•of: •r' ry,I hereby certify that this Sales Disclosure,to the be of -y •wledge and belief,is true,correct a.,: co .1. e r,qu/d by law,and is prepared in accordance with IC 6- .1cypl "'ea •roperty Sales Disclosure Act". /. k ♦1 A r t`e// �`e - �P eofSefer �/� /' / ' eofSeller ' I ` (laryl R Conk fJ/ WO Tai 6 Printed Name of Seller tan Date(MM/DO/nfl) Panted N. e of Seller Sian Date(MM/DD/YYM "F:.BUYER(S)/GANTEE(S)_APPLICATIONfE MPROPERT,Y_TAX,DEDUCTIONS-IDENTIFYIAEL' ITEMS THATAPPGI T' Kayla Houchin • Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 122 W 1st St IL Address(Number and Street) Address(Number and Street) Oakland City, IN 47660 it- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF TH IAT U YES NO CONDITION I YES NO CONDITION HQnU 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead Ty4 ch., residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling Sys[Crrlp residence,including county: R 418 W Columbia St ❑ 12 S.Wind Power Device Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Oakland City. IN 47660 Gibson ❑ Ej 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ I71 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 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) 0 /S/f 3a�- 9 -02 City,State ZIP Code County Primary property owner contact name E-mail