HomeMy WebLinkAboutHomestead_Jacobs (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Stacy Brown Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 . 812-759-5555
Dry,State,and ZIP Code Telephone Number E-mail
E-SEilalk-MITareAktOTA77-Tr—7;1E1:77-- 17-'75-711—ir '-c'-u. :-,:a-77.-777Q
I aresa Kemey
Seller!-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
322 E Ohio Street
Address(Number and Street) 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
a d/Complete as .e e .; ed by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
I aresa Kerney 5 at.< ji2 tu
Printed Name of Seller ''' a Dote(mm/a n Printed Name of Seller Sign Dote(MMIDEMYYYY)
IT:,-IIINEFt(SVG—R"ANTFEE(STSAP;PLIG-AffoNIODVPROPERTSWAX,DEOUG=1:10–N–ST-tTI-DENfirdtAn TITE-MSiTHAficAPREW-c:,--C.--:7---'':
Kenneth A,A.Jacobs
Buyer!'Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
811 S.Seminary St.
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT Ahloy.IC
t ii> -VV
YES NO CONDITION YES NO CONDITION
1
Fl 0 1.Will this property be the buyer's primary Fl fl 3.Homestead 'To 0 -
residence? Provide complete address of primary n Fl 4.Solar Energy Heating/Cooling Sysgy
residence,including county:
n ig 5.Wind Power Device
322 E Ohio Street
Address(Number and Street) 0 Fl 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson n Fl 7.Geothermal Energy Heating/Cooling Device
City,State ZIP de County
0 8.Is this property a residential rental property?
0 2.Does the buyer have a homestead in Indiana to be Fl
vacated for this residence? If yes,provide 0 Fl 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)
a Z-7,--/.7107A-5.- 0207 6 f-61,2 2
City,State ZIP Code County
Primary property owner contact name E-mail