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HomeMy WebLinkAboutHomestead_Elpers (45) INDIANA SALES DISCLOSURE FORM SDF ID: 2017 _ Page 2 D. PREPARER Kathy Masterson 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 kathy@swinland.com City, State,and ZIP Code Telephone Number E-mail E. pSE+LLLER(S)/GG+�RINNTTOOR(S) NEI 9obal di<atidn Company A 1• Seller 7-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2707 N 118th St Address(Number and Street) Address(Number and Street) Omaha, NE 68164 Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct a m to astirpd b d, prepare ao rtic wi IC 6-1.1-5.5, "Real Property Sales Disclosure Act". /�{n , Al USG 1 (I, AI v` An of Seller �� Signature of Seller \-)Printed Name of Seller ign Date(MM/DD/Y ) Printed Name of Seller Sign Date(MM/DD/YYYY) F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL!6 ISJHA D Garrett W. Elpers i��//pp Buyer 7-Name as appears on conveyance document Buyer 2-Name as appears on con a a document 12619S200E JU"L nce 1 3 2017 Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 _ 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 System residence, including county: T 11397 S 50 E ❑ a 5. Wind Power Device Address(Number and Street) ❑ 4 6. Hydroelectric Power Device IHaubstadt, IN 47639 1 Gibson' ❑ ® 7. Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ '9 8. Is this property a residential rental property? El tl 2. Does the buyer have a homestead in Indiana to be ❑ D 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. Not available in all counties.) Address(Number and Street) (9 6) -a /7 -Opp -©D t 139-Y City,State ZIP Code County Primary property owner contact n me E-mail