HomeMy WebLinkAboutHomestead_Pohl INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Dr:PREPARER_ '•-.�. .- —`--� �: " -
LANA C.HARPER CLOSER
Preparer of the Saks Disclosure Form Tide
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES, LLC
Address(Number and Street) Company
EVANSVILLE, IN 47708 812-468-8485
City,State.and ZIP Code Telephone Number
Email
Linda L Paris
Seller I-Name as appears on c seyance ocumen[ Seller 2-Name as appears on conveyance document
3 9 r on &44.2/
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and com teas required by law an repared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
v/ 1 . CC/Z.L/1—.
Sign ture of Selina Signature of-Seller
G C . geriS 9-16,-/Cc
Printed Name of Seller Sian Date Dam/BD/WM Printed Name of Seller Sian Date(M.M/DODITI1
•Fi BUXER(S)/GRANTEE(S)-.APPIi1CATION-FOR'.PROPERTI'TAX'DEDUCTIONS IDENTIFY:ALL'ITEMS THAT AP,PIY._I - .i1.7. _ •
Adam James Pohl Courtney Lynn Naas 'A��
Buyer I-Name as(mam on tone dorume Ryer 2 Name as appears on d 11 Ad sc((Auu/u heron 4trreet/ 1 p�I°P G ' �, rT Yafith //a 4L7(
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TH IS PROPERTY. IDENTIFY ALL OF THOSE THAT APPL ' 'TY AUDITOR
YES NO CONDITION YES NO CONDITION GIBBON OOUN
is n 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
/any/ `�es �ncrnc udit> county: ❑ 0 5.Wind Power Device
A.. • 'umber an.Si, h ❑ SI 6.Hydroelectric Power Device
Et I ✓ .1 r �� ❑ TA 7.Geothermal Energy Heating/Cooling Device •
City.State ZIP Code County '
pi, 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 ❑ 0 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) p. Z
City,State ZIP Code Z to-Z O -a O -3 0Q 600 31S-cc
C
/
ounty
Primary property owner contact name E-mail