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HomeMy WebLinkAboutHomestead_McCoy (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 _D_I?EEPARERO ' . r -a 7F';r ::7"...;: -.7 -..-. - 77'.:17:7"- .. ';.7.1-,:r !,-: . --` ",-u—. SHERIL.GREENE Prepare,of the Sales Disclosure Form Tide 1122 E. OHIO ST Address(Number and Street) Company PRINCETON, IN 47670 ' 812-664-1005 City.State,and ZIP Code Telephone Number E-mail I E.SEEL"ER?S)IGRANTOR(Sj- ,. --' - ,r:r" i-j,: _" .. . MIKE R RI OCKHOI D TINA NI BI OCKHOI D Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 423 F GI FNDAI F ST 423 F GI ENDAI E ST Address(Number and Street) Address(Number and Street) PRINCETON IN 47670 PRINCETON IN 47670 _ 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 req 'r; witty law,and is prepared in accordance wit 6-1.1-5.5,"Real Property Sales Disclosure Act". tstgnalifreofSeller \ I crtgrfatifs_eofSille r MIKE R RLOCKHOLD - 051''CS//2017 TINA M BLOCKHOLD 05C/51/2017 Printed Name ofSeller Sian Date(M.N/DD/YYYY) Printed Name of Seller Sian Dote(MM/DD/YYYY) "Ft,BUYER(S)JGRANTEE(SQL—LAPP,E[CA(8%. -ITEMSTHAT'AP-P -- _ _ _ JOHN WAYNE COFFEY NANCY MCCOY ".1:e Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 908 N. SEMINARY ST 908 N. SEMINARY ST '4, Address(Number and Street) Address(Number and Street) '9` PRINCETON, IN 47670 PRINCETON, IN 47670 C/�S' THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.. \ YES NO CONDITION I YES NO CONDITION 4., 0 ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead O'P residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ Q 908 N.SEMINARY ST S.Wind Power Device Address(Number and Street) ' ❑ Q 6.Hydroelectric Power Device PRINCETON, IN 47670 I GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Q 2. Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 0 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) 2/,-/a - o 4,-903 003 667 o a k City,State ZIP Code County Primary property owner contact name E-mail