HomeMy WebLinkAboutHomestead_Miller (7) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Brian K.Mahoney Attorney
Preparer of the Sales Disclosure Form Title
822 Main Street,P.O. Box 176 Mahoney Law Office
Address(Number and Street) Company
Petersburg,IN 47567 812 354 8121 mahoneylaw(a)nwcable.net
City,State,and ZIP Code Telephone Number E-mail
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EcSELL'ER(S)/.GRANTOR(S) _z.n. •{ •.. ,- ' - f.
Susan I Rrittain as Trustee of the Relva S Culbertson RLT
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
4140 N Prides Creek Dr
Address(Number and Street) Address(Number and Street)
Petersburg IN 47567
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co r plete as required b law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
, I
Signature of Seller Signature of Seller
Susan I Rrittain Trustee
Printed Name of Seller Sian Date(AIM/DD/Yrv17 Printed Name of Seller Sign Date IMM/oo/rrn')
t ::SITI YERV,GR`ANTEE(S)L`--APP.EIGATIONyF,ORPROPERTYITAXyDEDUGTIONSE IDENTIFY?AL'L:ITEMSITHATtARREYUT*77""7--
Buyer a e Miller Mama B.Name as
FILED
Buyerl-A'ame as appears on conveyance document Buyer2-A'ome as appears on conveyance document 1 ®®��----11
319 W Trussler Street 319 W Trussler Street
Address(Number and Street) Address(Number and Street)
Oakland City,IN 47660 Oakland City, IN 47660 FEB 2 2 2017
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.G I BS ON COUNTY AUDITOR
is
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary Ertl 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Gibson ❑ Fl 7.Geothermal Energy Heating/Cooling Device
City;State ZIP Code County
❑ 1%1
8 Is this property a residential rental property?
Ern 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ 5 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.
'3 1 el bf • 1 ru,S 5 ( e-c cS i- - Not available in all counties.)
Address(Number and Street)
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City,State ZIP lode County
Primary property owner contact name E-mail