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HomeMy WebLinkAboutHomestead_Clark (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER _ r. =.r ., . ..`- ' ..!iv'isi .-_ ..^::`, C/_' F.foci- j t.7s f±a.. rl ` 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 bti(a)mw.twcbc.com City,State,and ZIP Code Telephone Number E-mail _ _ _ _ ;y :-� � ,. rte•;-; _ E.SELLER(S)/GRANTOR(S) Klenith,l Fnglish Ruth E English Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 4250 N SR 65 4250 N SR 65 Address(Number and Sweet) Address(Number and Street) Patoka IN 47666 Patoka IN 47666 ' Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as re ",-by law and 's prepared in accordance with 6-1.1-5.5,"Real Property Sales Disclosure Act". aia Signature of Seller / Signature / Signature of Seller Klenith J Fnglish /2-- --2e1 /t0 Ruth E Fnglish /a--2-;30/4 Printed Name of Seller Sign Date(MN/o0/1Y11 Printed Name of Seller Sign Date(NM/no/YYYI) F.BUYER(S)/GRANTEE(S)-APPLICATION FOR,PROPERTY-TAX,DEDUCTIONSIDENTIFY:ALGITEMS THAT APPLY:_ Ralph E. Clark Maudie G. Clark Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 518 W.8th St. 518 W.8th St. Address(Number and Street) Address(Number and Street) THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THI'PROPERTY.OIDENTIFY ONDITION OF THOSE THAT APgq C(` 2 2O1r. YES NO CONDITION U 1. L/ o 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating2 At4 ' ' residence,including county: ❑ 0 S.Wind Power DGI ON COUNTY AUDITOR 4250 N SR 65 Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Patoka, IN 47666 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 0 ❑ 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. 518 W.8th St. Not available in all counties.) Address Bicknell, IN Brand Street) kg°L� a(0-D r"-2_ lop- Q03. / / S-D1^Bicknell, IN 47512 V1 /v'�/H\� 1 L City,State ZIP Code panty Primary property owner ontact name E-mail