HomeMy WebLinkAboutHomestead_Bradshaw INDIANA SALES DISCLOSURE FORM 'y, SDF ID: Page Page 2
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.D'i:P,REP'ARER? --....".>-' -'- - , .-a.-� -ts:.__ s.• -. r_ - - .�__�....-_
Britany Barnes Title Agent
Preparer of the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc
Address(Number and Street) Company
Princeton,IN 47670 812-386-1687 britany.bti @mw.twcbc.com
City,State.and ZIP Code Telephone Number E-mail
Susan Jayne Bierman
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document •
741 E 750 S
Address(Number and Street) Address(Number and Street)
Ft Branch
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".
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Signature of Seller Signature ofSeller
Susan Jayne Bierman
Printed Name of Seller Sion Date(M31/DD/YYY1) Printed Name ofSeller Sign Date(.MM/DD/YYYY)
F.:BUYER(S)/GRANTEE(S)`-APPLICATION'FOR•PROPERTY.TAX DEDUC-TIONS;ADENTIFYALLITEMSTHATAPP.LY.IXt '
Evangula A Bradshaw ������rrrrr'''''''''''999999
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears an conveyancefinit
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741 E 750 S
Address(Number and Street) Address(Number and Street)
Ft Branch, IN 47648 SEP 310 2016
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOWElgo II.,y,0UNTY AUDITOR
YES NO CONDITION YES NO CONDITION
•
Q ❑ 1.Will this property be the buyer's primary 1 ❑ 3. Homestead
residence? Provide complete address of primary ❑ rs 4.Solar Energy Heating/Cooling System
residence,including county: ❑
741 E 750 S 5.Wind Power Device
Address/Number and Street) ❑ 13 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 12 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 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)
a(o- IQ -ao -/oo-oba . 113 - ORS
City,State ZIPCode County
Pnmary property owner contact name E-mail