HomeMy WebLinkAboutHomestead_Przymus INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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CHRISTINA LENFERS CLOSING AGENT
Preparer of the Sales Disclosure Form Title
501 MAIN ST STE 101 BOSSE TITLE CO
Address(Number and Street) Company
EVANSVILLE IN 47708 812-421-4000
City,State,and ZIP Code Telephone Number E-mail
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MAURICF F RATHON I INDA L BATHON
Seller I-Name atpppears on conveyance document Seller 2-Name as appears on conveyance document
4D E 1 51) 5rin--Ne--.
Ad" (Nu Street)ch. 3 ) ttitoLi& Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
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and compl as require byss , .nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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J ti s . di. az:ion)
Signatur 1 eller Si afore of Seller
MAURICE E BATHON 06/09/?016 LINDA I .BATHON 06/09/2016
Printed Name of Seller Sian Date(BM/D0/1111) Printed Name of Seller Sian Date(MM/DD/WYY)
:Pi BUYER(S)'JGRANTEEtSilif.AEPLICATION,FOR`PROP.ERT,YLTAXDEDUGTIONSIIDENTIFY:ALLiITEMS,THATAPPLY: .:
MATTHEW J. PRZYMUS JOANNA PRZYMUS
Buyer I•Name as appears on conveyance document Buyer 2-Name as appears on coFncloci eta,/ ED
6232 ROBERTS RD SAME
Address(Number and Street) Address(Number and Street)
MARION IL 62959 JUN 1 0 2 016
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL9liWs1t&PION.T.Y AUDITOR .
YES CONDITION I YES NO CONDITION
0 1.Will this property be the buyer's primary Er ID 3.Homestead
residence? Provide complete address of primary 0 2".- 4.Solar Energy Heating/Cooling System
()Hi e rViSly,isluding county:
[I Er'5,Wind Power Device
Arr'u7,pdertie .7.1„1/4.).. "7th ye 6,4sin_L Er 6.Hydroelectric Power Device
0 2-..7.Geothermal Energy Heating/Cooling Device
City;State ZIP Code County
0 Er a residential rental property?
0 0 2.Does the buyer have a homestead in Indiana to be .Is this 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)
A)&)' —1 9— 1g- loa - 000. 3Q-002S
City.State ZIP Code County
Primary property owner contact name E-mail
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