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HomeMy WebLinkAboutHomestead_Cundiff 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)I GRANTOR(S) Melissa M. Michel Seller 1 -Name as appears on conveyance document Seller 2-Name as appears on conveyance document 7343 S 200 E Address(Number and Street) Address(Number and Street) Ft Branch, IN 47648 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 Property Sales Disclosure Act". Mc,P('>- ill, ArnA.n.h0� St nature I Seller' , - Signature of Seller Melissa M. Michel Ss- Iq-1 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 y � $ �} Brandon L. Cundiff o Buyer 7-Name as appears on conveyance document Buyer 2-Name as appears on t 4720 Timber Lane,Apt 434 2 Address(Number and Street) Address(Number and Street) AUG 2 6 alb Evansville, IN 47715 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. yES NO CONDITION y(�ES� NO CONDITION /\ ❑ 1. Will this property be the buyer's primary 'Le- / ❑ 3. Homestead residence? Provide complete address of primary ❑ 4. Solar Energy Heating/Cooling System residence, including county: /yam,, 7343 S 200E ❑ 1—'= 5. Wind Power Device Address(Number and Street) ❑ (t ft 6. Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ p 7. Geothermal Energy Heating/Cooling Device City, rate ZIP Code County ❑ (e. 8. Is this property a residential rental property? ❑ 2. Does the buyer have a homestead in Indiana to be ❑ ❑ g. Would you like to receive tax statements for this vacated for this residence? If yes, provide complete c 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) 676- i n _ Ito - 3 oo - ©o. 3si - 3 City, State ZIP Code County Primary properly owner contact name E-mail