HomeMy WebLinkAboutHomestead_Naas (13) INDIANA SALES DISCLOSURE FORM SDF ID: .- Page 2
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 britanylti@mw.6vcbc.com
City,State,and ZIP Code Telephone Number E-mail
Charles E Chambliss i_j R. , Terry B Chambliss
Seller I-Name as appears or!conveyance document Seller 2-Name as appears on conveyance document
12437 S Owensville Rd 12437 S Owensville Rd .
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 complete as required by law,and is prepared in accordance with IC 6-1. - .5,"Real Property Sales Disclosure Act".
/A6A4 1 AA-1,,,tal
Signature of Seller Signora 1 of Seller
Charles E Chambliss, i g . Terry B Chambliss
Printed Name of Seller Sian Date(1.1M/00/Yr110
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
is 0 1.Will this property be the buyer's primary 12 j 3.Homestead
residence? Provide complete address of primary 111 RI 4.Solar Energy Heating/Cooling System
residence,including county:
12437 5 Owensville Rd. 0 E 5.Wind Power Device
Address(Number and Street) 0 p 6. Hydroelectric Power Device
Haubstadt, IN 47697 Gibson
10 121 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 RI 8. Is this property a residential rental property?
0 (1:I 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide III RI 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 6.Re?-th we ooth36.? a a y
City,Stare ZIP Code County
Primary property owner contact name E-mail