HomeMy WebLinkAboutHomestead_Coleman (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
ID.PREPARER .: ` . - - . - ' - - - - _. ., -
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINA(tilREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number
E-mail
,E.SELLERS)/GRANTOR(S)• -
Ronald D Northenor q Sharon E Northenor
"A.,:eller I-Name
appegrs on
l/ v4nce o[ument Se/Ie Name appears on conveyance document
CAddi—ess(Number and Street J dress( umbe�and So-eet).
I✓v75 ✓r'/A�/.,ZP'✓ 317 7.21
`
Under penalties of perjury, I hereby 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 Pr Sales Disclosure Act".
std 4, 1t,,erz (C) 7? A
Abet
' Signature of Sell& �� C SignatureofSeller - -..,.
Ronald D Northenor C6/27i 47/4 Sharon E Northenor .2 ybe
Printed Name of Seller —S(an Doti(MM/DD/YYYl1 Printed Name of Seller ,-:".'•Sin Date'(M1t/DD/YYY17
F:BUYERS)%GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY , - _ - /..177_
Michael L. Coleman
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on con drstept
X IDUS MiU Sc. tC 1 D
Address(NumbeTand SlreeQ' Address(Number and Street) X,
Y2 n Act}On .1-A) I-t 7(21 O
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THDSE�
--YES- -NORcouomoN I=YTS— xo�coNmnoNGIBSON COUNTY AUDITOR
0 1.Will this property be the buyer's primary � 3.Homestead
residence? Provide complete address of primary ❑ SI 4.Solar Energy Heating/Cooling System
residence,including county: ❑ SI
222 E Clark St 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson n Fl 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 12 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) '^1
City.State ZIP Code County av - I -O I L)DI - 000 ' 4S- 0a
Primary property owner contact name E-mail