HomeMy WebLinkAboutHomestead_Briggs (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER _�-�- - - ,.• -F - - - - - -
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
_4703 THEATER DRIVE _ REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINAc REGIONAL-LT.COM
City,State and ZIP Code Telephone Number E-mail
•£.SELLER(S)/GRANTOR(S) _. .._ . . . . --- -._ ._
Rodney R Miller SR Mama B Millar
�r Name as appears oni�5�on}ryan�ocument � Seller 2-A'amea�nveyance document
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dress(Number and Stree Address(Number and Street)
) tA C.e
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".
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Signature of5e11¢r I I ( �7 Signature of Seller r
RodneyR Miller SR •`O-\�D' f Mama B Miller Q '. ( lQ l')
Printed Name of Seller Sian DY.e(MM/OD/n'Y} Printed Name of Seller Si n`Date Dal/DO/YYYY)
F.BUYER(S)/GRANTEE(S)_APPLICATION.FOR PROPERTY TAX.DEDUCTIONS1DENTiEY,ALL,ITEMS THAT7APPLY. `_T_ •._ _._ _ .
David J. Briggs Loretta A. Briggs
Buyer I-Name as appears on conveyance document Buyer 2.Name asap rs on conveyance document
�y1 3 /� �_�c c t e r 5>:-r-t.t. i- k �3/ 9 i• ti sidiz f -
-Address(Number and Street) Add1 (Number and Street)
x on 4:
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 __
❑ 1.Will this property be the buyer's primary �❑ 3.Homestead �
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling mm�
residence, including county: J -�
319 W Trussler_- ❑ 0 5.Wind Power Device UN 2
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device '1 20/7
Oakland C Y, IN 47660 Gibson ❑ Fl 7.Geothermal&clergy ,flag/Cooling Device
City State Code county �tBB J
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property �lti �!7;jy,'. ::-rty?
vacated for this residence? If yes,provide ❑ fl 9.Would you like to receive tazrha1:vognts for this
complete address of residence being vacated, property via e-mail?(Provide contaCfrrmotion
including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
2 to - IN - 1 9-IO I - 000 SI $ 007
City,State ZIP Code County
Primary property owner contact name E-mail