Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Homestead_Moss
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Becky King Closing Services Preparer of the Sales Disclosure Form Tide 7820 Eagle Crest Blvd.. Ste 201 Regional Title Services Address(Number and Street) Company Evansville, IN 47715 812-759-5555 becks.kingeregionaltitlellc.com City,State,and ZIP Code Telephone Number E-mail E..SEt:I;ERjSyGRAp',T.OR(S)$._i==P -�'- '�--_. . ->:-E Brett M Cargal Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 204 N Smith St Address(Number and Street) Address(Number and Street) Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co lete as see uire I by la` .nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature ofSeller Signature of Seller Brett M Cargal 11/01/2016 Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(M.M/DD/YYYY) 1;FfBU}ER(S1/GRANTEECatABPLICATION F,OR;EROPERP6TAX(DEDUCTIONS€WENTIEWAL�t£ i• 4 71"-C Charles J. Moss Ashley D Moss Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance document 1662 S. Hoosier Ave. same r'OV 3 . 2016 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 OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION S ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System residence,including county: n 204 N Smith St 5.Wind Power Device Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Owensville. IN 47665 Vanderburqh n 1g 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ig Fl 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 ❑ SI 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) t�y(/ rte/ Ciry,Sm:e ZIP code County V © '7- /V I- 000 O(or Oa 2- Primary property owner contact name E-mail