HomeMy WebLinkAboutHomestead_Ceney INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
15S.PREPARERF±',. 7.'1'tZ-2:::17.;:-7-,P47 :l'T 7-\;77.71-1 7k.'-1 fi::U-r:::f;7;:Ti 7,7,77 :-it'-. ; ,:_t.:—_ -V-,:ztc- M.-. t:1: --;
Becky King Closing Services
Prepare:of the Sales Disclosure Form Title
7820 Eagle Crest Blvd., Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 becky.kingeregionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
lir SELLERST/GRANTOR(STF 7 7--±'T - ;2;=I..-.:-N;r-----1..,Th'`,7.7'^..-1-t-71-j,77,•-zaz,r(2-.5,,:-7:24.7.,,Tc-.7.:77::::-:,---,:...-.-:-7-7.7,---,--72--.1-;:;,-,----.1-77:-,::-:
Ida M Leveron
Seller]-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
201 S PrinceSt Apt 305
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an complete as re uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
c
Signature cg Seller Signature of Seller
Ida M Leveron 12/21/2016
Printed Name of Seller Sian Date(1414/DD/TYY1) Printed Name of-Seller Sion Date(W-1/10D/1171
LE.BUYER(Sf/GRANTEEtSAPPLICATION,FOR.PRORER17/3AX"DEDUGTIONSglIDENTIFAIAlielTEMS:THAVATREYri _ :LI:
The Sarah A.Ceney Living Trust
Buyer 1-Name as appears on conveyance document Bayer 2-Name as appears on conveyance d . t
PO Box 113 It-_I ,.
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 THA19
fr .
YES NO CONDITION I YES NO CONDITION ditin,
ig D 1.Will this property be the buyer's primary is ri 3.Homestead --riro,?
residence? Provide complete address of primary 0 4.Solar Energy Heating/Cooling System
residence,including county:
D s 5.Wind Power Device
525 S 9th Ave
Address(Number and Street) n NI 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ri NI 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code Counr
TA 8. Is this property a residential rental property?
0 n 2. Does the buyer have a homestead in Indiana to be 0
vacated for this residence? If yes,provide n TA 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)
y•
Address(Number and Street) /
Clg-0 73 --(1‘-01100- COO, 06 3- 009
City,State ZIP Code County
Primary property owner contact name . E-mail