HomeMy WebLinkAboutHomestead_Ungetheim (3) INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Prepare(of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 teresa @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
P & D Rentals LLC, an Indiana limited liability company
Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document
467W1100S
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true,correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
X ie f lSell/L It
Signature of Seller Signature of Seller
Duane L Elpers,Managing Mem er 4/7/2017 4/7/2017
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEM' PLY
Emily C. Ungetheim
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyan a docume
1003 Adam Ct t4PR 71
Address(Number and Street) Address(Number and Street) 4 1 20/7
Haubstadt, IN 47639
-
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyer's primary El ❑ 3. Homestead
residence? Provide complete address of primary ❑ p 4. Solar Energy Heating/Cooling System
residence, including county:
❑ El 5. Wind Power Device
109 S 4th Ave.
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, IN 47639 I Gibson ❑ El 7. Geothermal Energy Heating/Cooling Device
City, Sta ZIP Code County ❑ El 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
24-/9z3/-3o}txn y69co-1
City,State ZIP Code County Primary property owner contact name E-mail