HomeMy WebLinkAboutHomestead_Wetekamp INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
•.10.115REPARER:._ :2_._-T"L T-T1J1,L. _._...1-_,__ L.-- .::L.. :."-:1;..i. -I:L=7 _1,.._, ,f---7---,-in----::
Karen S.Creek Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main Street,Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000 closing.dept@ieffbosse.com
City,State,and LP Code Telephone Number E-mail
•E:SELLER(SVGIOINTOR(S)I.LA7:‘, t7.- . :,:',.''. - I".-.- :.r:s;.:7-ct-:7 Ir- :---:::_
Roy Stephen Jenkinq
S 1-Name a A A4S
ppears on conveyance document Seller 2-Name as appears an conveyance document
E C JE411)
;el
Address(Nun and Street) Address(Number and Street)
2 c&ter-A‘ik LEA) 6774C/F
Under penalties of perjury, thereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and coin I lete a equ' •d b law,an is prepared in accordance with IC 6-1.1-53,"Real Property Sales Disclosure Act".
Signature 'Seller Signature of Seller
Roy Stenhen Jenkins 08/26/2016
Printed Name of Seller Sian Date IMM/DIWYVYY) Printed Name of Seller Sian Date(.1fM/DD/YYYY)
F.:311YtR(S)'atANTEE(S)17:APPLICATION EOR.PROPERTY,TAX DEDUCTIONSf:IDENTIEY ALLITEMS THAT-APPLY:, , ..,-T-11.7-1-.„1.: ;.
Nathan Wetekamo Hannah K.Wetekamp
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance dot':, •
305 E. Ulen Street 305 E. Ulen Street •
, ,
I
Address(Number and Street) Address(Number and Street) .
‘ - ICJ tir
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT A.,'
YES NO CONDITION I YES NO CONDITION GIBSON CO ti"Ty .A:10110k
12 p 1.Will this property be the buyer's primary IN 0 3.Homestead
residence? Provide complete address of primary 0 NI 4.Solar Energy Heating/Cooling System
residence,including county:
111 Fl 5.Wind Power Device
305 E Ulen Street
Address(Number and Street) D 19 6. Hydroelectric Power Device
Fort Branch, IN 47648 Gibson p 12 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
0 EI 2.Does the buyer have a homestead in Indiana to be 8.Is this property a residential rental property?
0 Fl
vacated for this residence? If yes,provide 0 IN 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)
2 lo--1 9-t3-30/ -00o58-90a b
City,State VP Code County
Primary property owner contact name E-mail