Loading...
HomeMy WebLinkAboutHomestead_Simms INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER ._`r .. -.-ti-.? Tt ., 7r 3: _ _,._ `j7_ .7 . :2=^a xC. :-r 1" .F 7 __.".£?-r Bryceann Cutsinoer Preparer of the Sales Disclosure Form Title 226 W Broadway Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 812-386-1687 btiemw.twcbc.com City,State and ZIP Code Telephone Number E-mail E:SELGER(S)/GRANTOR($) ' 4-...----1-. L.: _: ,:.7.-kL,: - • :77__ 41 : t":- , Timothy R Riley Rhonda S Riley Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 10360 S Pheacant Run 10360 S Pheasant Run Address(Number and Street) Address(Number and Street) Haubstadt IN 47639 Haubstadt IN 47639 • Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and c m 1.•e as rerired/'/py�w,-and is prepared in accordance with -1.1-5.5,"Real Prope les Disclosure Act". Signature ofSelle �j / Signature ofSeller ( Timothy R Riley - �3- )t Rhonda S Riley 9',3-I LP Printed Name of Seller Sian Date(MM/DD/YYYV7 Printed Name of Seller Sign Date(M/DD/YYYY) F.BUYER(S)/GRANTEEIS)'-APPLICATION.FOR PI20PERTY.TAXiDEDUCTIONS=IDENTIFY ALL ITEMS THAT{APPLY . _,_,_.•:,, Bradley J.Simms Bet House-Simms Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance dacu 512 5.Ninth Ave. 512 S. Ninth Ave. Address(Number and Street) Address(Number and Street) / THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL 0J6SET PPLY. eo,6; YES NO CONDITION YES NO CONDITION Orl/.. V 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead _004/2,y residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cools gSystem residence,including county: El ❑ i7/T 10360 S Pheasant Run S.Wind Power Device Or, Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt. IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County Q ❑ 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. 512 S.Ninth Ave. Not available in all counties.) Address(Number and Street) Haubstadt,IN 47639 Gibson 672‘_/7- 1/45t -.joo - ooa- 0/9- 0a' City,State ZIP Code County Primary property owner contact name E-mail