HomeMy WebLinkAboutHomestead_Queen INDIANA SALES DISCLOSURE FORM SDF ID: 26 - 17 - 1100181 Page 2
D.PREPARER
Mercedes Barkley Deed Specialist
Preparer of the Sales Disclosure Form Tide
662 Woodward Ave Title Source Inc.
Address(Number and Street) Company
Detroit,MI 48226 888-848-5355 MercedesBarkley @titlesource.com
ow,State.and ZIPCode Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
-
Dane M.Queen Katherine L. Queen
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2639 Julie Dr W 1793 N 350 E
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Princeton, IN 47670 Filtifix
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true correct
and comple e as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sal e�hfty�J c
_ _ GIBSON COUNTY AUDITOR
.lure of Seller Signature of Seller
Dane M.Queen 0,`I/Ay/dot? Katherine L. Queen
Printed Name opener Sign Date(.MM/0O YY) Printed Nap o Seller Sign Date(MA/ODAYM
F.BUYER(S)JGRANTEEE -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY j
Dane M.Queen �dog�
Buyer I-Name as appears on conveyance document Duyer 2-Name as appears on cf nf „„„ED
JL
2639 Julie Dr W
•Addres(Number and Street) Address(Number and Street)
Princeton, IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALLGi t-••• it•• • •.YY AUDITOR
YES NO CONDITION YES NO CONDITION
m ❑ 1.Will this property be the buyer's primary m ❑ 3.Homestead
residence? Provide complete address of primary ❑ m 4.Solar Energy Heating/Cooling System
residence,including county:
2639 W Julie dr ❑ ❑ 5.Wind Power Device
Address(Number and Street) - ❑ m 6. Hydroelectric Power Device
Princeton, IN 47670 26
Ciry.Smte ZlPCodc coanty ❑ m 7.Geothermal Energy Heating/Cooling Device
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ ❑ B.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ ❑ 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.)
Address(Number and Street) 7�
Dane M.Queen '1` `5
- lL- 1 '(b( - 9-is. l -r_11,--1
City,State ZIP Code County
Primary property owner contact name Email