HomeMy WebLinkAboutHomestead_Palmer 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. SELLERS)/GRANTOR(S) fyy_ 1
Michael T. Gentry Patricia A. Gentry
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on copvffr a do g'nt
PO Box 313 PO Box 313 M
Address(Number and Street) Address(Number and Street)
Patoka, IN 47666 Patoka, IN 47666
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true, correct
ac ./
omplete as required bey law, and is prepared in accordance with 6-1-1..11�-5_.5, "Real Property Sales Disclosure Act".
CT
.\rNA-LiVek Signature of Seller Signature of Seller
Michael T.Gentry C) /2DA1 7 Patricia A. Gentry (C)72- tA0/ 7
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller in Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
David L. Palmer
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
Old State Rd 65
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
\ NO CONDITION YES NO CONDITION
Nii ❑ 1. Will this property be the buyer's primary l�D ❑ 3. Homestead
residence? Provide complete address of primary O .l 4. Solar Energy Heating/Cooling System
residence, including county:
❑ 21 5. Wind Power Device
108 S Main St.
Address(Number and Street) ❑ a 6. Hydroelectric Power Device
Patoka, IN 47666 ! Gibson ❑ 7. Geothermal Energy Heating/Cooling Device
City, State\ZIP Code County ❑ CJ`8. Is this property a residential rental property?
❑ �+� 2. Does the buyer have a homestead in Indiana to be ❑ Lr 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)
ak- a"{ - a.5 - loo-tnn ,t-k (g -coo
City,State ZIP Code County Pnmary property owner cc .t name E-mail