HomeMy WebLinkAboutHomestead_Windell INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Amber Kellams Closer
Preparer of the Sales Disclosure Form Title
606 Main St. Dubois County Title Co., Inc.
Address(Number and Street) Company
Jasper, IN 47546 812-482-1696
City,State,and ZIP Code Telephone Number E-mail
_E:.SEL'LER(S)`/GRANTQR(S)} —— L -- ---- ---- --The Estate of Juanita M Marvel 6
Seller Name as appear nn conveyance document a Seller 2 Name asa ears on conveyance,�^_r /d\// pp eyonce document
Address N �r and Street) i Z- ^ (2 7 7 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 c
by as quired b law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature eller Signature of Seller
Rodney Ray Marve Per ReD 1/10/17
Printed Name of Seller Sign Date(MM/DD(YYYY) Printed Name of Seller
/ Sign Date(FIM(DD/YYYY)
Fi-
as appears on conveyance document Buyer 2-Name as appears on conveyance dot
0230 W- /n'KEmso Ar >ve • ��
AAdddrresss(Number and Street) • `{'��7o Address(Number and Street)
`it St-/A/r.F�A✓1
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFI'ALLQf8, OS t.(f,T APPLY.
YES NO CONDITION YES NO CONDITION O�0041 m�dd.,; _
[�❑ 1.Will this property be the buyer's primary K ❑ 3. Homestead t t#
Akio
residence? Provide complete address of primary ❑ 2"4.Solar Energy Heating/Coolie sitem
residence,including county:
Sa,/).�(_ ❑ [v]' 5.Wind Power Device
Address(Number and Street) ,-) � 6. Hydroelectric Power Device
/ b S GA ❑ 2' 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County Ti2. Does the buyer have a homestead in Indiana to be ❑ IJ 8. Is this property a residential rental property?
III vacated for this residence? If yes,provide Ell L9.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)
2eo-/Q -/99 -i0 2.-/ ocn 63/ oaf
City State ZIP Code County
Primary property owner contact name E-mail