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HomeMy WebLinkAboutHomestead_Bolin INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ID. PREP.ARER1 ' . - }L:::' . , i, j, :I..;',V;.. i.(B flE::.•k.:_. IC I, •.a•, . Becky King Closing Services Preparer 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.king @regionaltitlellc.com City,State,and ZIP Code Telephone Number E-mail ,E.SELL'ER(S)/GRANTOR(S)IZ1t : _ i ,. •'. # n.' I„:,..4 ; r_ln. +, 4I,i . , :rEi,lt'!i!-- s.; it, i" ria:- , Alyssa Brnnks Seller 1-Name as appears on conveyance document Seller 2-Name as appears an conveyance document 9700 Winyard PI Address(Namber 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 to as r quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". •1 I 214 tCp Sig.at a of Seller Signature of Seller Alyssa Brooks 12)28)2016 Printed Name o Seller Sian Date MM DWD m9) Printed Name of Seller Date MM/DD(YYYYI ;F.BUYER. B)/GnRANT GRANTEE -APPLICATION FOR PROPERTYITAX DEDUCTIIONS#IDENTIFY ALF,E S HA1 C,. ' ' Y p conveyance Buyer appears eya Ut'l. J V 2016 329 S Fifth Ave.Mt 21 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 � YBFfI&9� 2.......--111 1.Will this property be the buyer's primary ❑ 3. HomesteacTh residence? Provide complete address of primary ❑ igi 4.Solar Energy Heating/Cooling System Of res1id`ence, lu$iu county: ❑ 0 5.Wind Power Device Add a hLmberandStreet)i -i 11 I n �9C n is 6. Hydroelectric Power Device vVv' Sv gt 1X J Gi n s 7. Geothermal Energy Heating/Cooling Device City,State ZlP de County ❑ L�J n 8. Is this property a residential rental property? 2. Does the buyer have a homestead in Indiana to be 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. Address(Number and Street) 26, - / 7 -o7 - A00 - Do '-i. 979 -0 City,State ZIP Code County