Homestead_Perkins INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
i.
Leon C. Stone President
Preparer of the Sales Disclosure Form Title
226 West Broadway Street Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 (812)386-1687
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) t•
Keith Perkins Tiffany Perkins
Seller 1'Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1522 S Dongola Road 1522 S Dongola Road
Address(Number and Street) Address(Number and Street)
Under penaities of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comple as requir by law,and is prepared in accordance with ICy,�.1-S.S,"Real Property Sales Disclosure Act".
7 /3/4 V/ 6 1 - IoI Obl0)ulb
Signature of Seller Signature of Seller
Keith Perkins Tiffany Perkins
Printed Name of Seller Sign Date(MM/DD/YYYYI Printed Name of Seller Si n Date(MM/DD/rWil
F.BUYFR(a)7r,RhNTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL Ippµ,CyI',Sppf` T A`d'q��'gt •
Eric Michael Perkins y "'
iuyell.Aamt m uppcwi conveyance document Buyer 2-Name as appears on conveyance document
13329 East Harrison Street nrT 7 2006
Address(Number and Street) Address(Number and Street)
Oakland City,
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITI•`
❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of prima LI -Li] 4.bola -• eating/Cooling System
residence,including county: ❑ ❑
1522 S Dongola Road 5.Wind Power Device
Address(Number and Street) ❑ 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
Ciry,State ZIP Code County
ig
❑ Q 2.Does the buyer have a homestead in Indiana to be El 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: •. . • • ' r ••• e information.
Not available in all counties.)
Address(Number and Street)
City, ZIP Code Coun 01 )(o -N-/9. 0100 -00 /. V/ a -00 6
ry
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