HomeMy WebLinkAboutHomestead_Jones (20) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER • . . , . ,_ . -
Britany Barnes Title Support
Preparer of the Sales Disclosure Form Tide
226 W Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 britany,bti @mw.twcbc.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(SJ -
Chandra Pollock Riley
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
903 E Water St.
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
I d complete as requir, y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
c� a \ ADO Q 1< I .Qa
Signature of Seller Signature of Seller
Chandra Pollock Riley LO-I3-IL
Printed Name of Seller Sign Date(1.04/DD/M11 Printed Name of Seller Sign Date(HM/DD/YMI
F.BUYER/C)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL IT �x$PPt vid E.Jones N uye on convnre document Buyerl-Name vs appears on conveyan JL.J LL
63 E Inwood Dr
Address(Number and Street) Address(Number and Street) JUN 1.4 2016
Princeton, IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION e NO CONDI
0 ❑ 1.Will this property be the buyer's primary ✓ n Homestead,
residence? Provide complete address of prim. • . • • • y. -. mg/Cooling System
residence,including county:
903 E Water St. ❑ 12 5.Wind Power Device
Address(Number and Street) ❑ I2 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 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 ❑ ES 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.
'o available in all counties.)
Address(Number and Street) ,
-246 -. 4 - a8 • 30 / - O0/. 750 - 0,)_ .;
City.State ZIP Code County
• mary property owner contact name C.