HomeMy WebLinkAboutHomestead_Holcomb (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
_Teresa S. Holifield _ Escrow Officer
Preparer 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) I
SPM Development Inc.
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
304 E State Rd 68
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
a/Itl po��lte� re�r� h��repared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
/Signature of Se er `A t_ q r ihft G�1- So C. Signature of Seller
---- - --: - Ift�C o • It-� 6/10/2017 6/10/2017
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller ign ate(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL ITEMS T T PP
Brian L. Holcomb Kassi L. Holcomb JO
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance do n
730 S Hall St 730 S Hall St (; �p/1/
1S
Address(Number and Street) Address(Number and SlreetJ Opp
Princeton, IN 47670 Princeton, IN 47670 OOVMTy
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 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ E 4. Solar Energy Heating/Cooling System
residence, including county:
❑ RI 5. Wind Power Device
2687 W Jill Dr.
Address(Number and Street) ❑ a 6. Hydroelectric Power Device
Princeton, IN 47670 I Gibson ❑ R1 7. Geothermal Energy Heating/Cooling Device
y, State ZIP Code County ❑ El 8. Is this property a residential rental property?
P 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.
IV S- f , c 5rte g/ Not available in all counties.)
Address(Number and Street)
a, L0- 11 - ( 5 - !O ! on ic 3R oa7
City, State ZIP Code County Primary property owner contact name E-mail