HomeMy WebLinkAboutHomestead_Scott INDIANA SALES DISCLOSURE FORM SDF ID: 2016 Page 2
D. PREPARER
Rocksan Underhill Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 rocksan @swinland.com
City. State, and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Charles Wayne Scott Patricia Scott
Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Sgoct s S.so(,)
Addre s(Number ang Street) / / / (/ Address(Number and Street)
.
Under penalties of perjury, I hereby certify that this Sales Disclosure,to est of my knowledge and belief, is true,correct
and complete as required by I w, and is prepared in accordance with I 6-1.1 5.5, "Real Pro Sales Disclosure Act".
r LI- _
Signature of Seller Signature of Seller
Charles Wayne Scott 7/7/2016 Patricia Scott 7/7/2016
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Adam B. Scott Christopher W. Scott
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on convetF n?e a$cu ent ED
10527 W. 450 S 10527 W. 450 S
Address(Number and Street) Address(Number and Street) _Nq
owensville, IN 47665 owensville, IN 47665 �
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIF, •e r • j 1YTY AUDITOR
YES NO CONDITION YES NO CONDITION
❑ 901. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary `��
residence, including county: ❑ 7-' 4. Solar Energy Heating/Cooling System
❑ fin 5. Wind Power Device
5404 S 850 W • v
Address(Number and Street) ❑ 6. Hydroelectric Power Device
'Owensville, IN 47665 Gibson ❑ 'aj 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ , 8. Is this property a residential rental property?
❑ P 2. Does the buyer have a homestead in Indiana to be ❑ (�❑7 g. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete /— property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) 36- 7 9-02- 300- tool. 5 -CQ I
City, State ZIP Code County Primary property owner contact name E-mail