HomeMy WebLinkAboutHomestead_Memmer (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)I GRANTOR(S)
Eric E. Powell Dana J. Powell
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
815 Highland Ave 815 Highland Ave
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660 Oakland City, IN 47660
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of m knowled•e and >-lie , is true,correct
and complete as r__d by law, and is prepared in accordance with IC 6:1.1-5.5, -cal Property a -- this losure Act".
k.- 411111.11"P
Signature of Seller Si.n Seller
Eric E. Powell 8/18/2017 Dana J. Powell 8/18/2017
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Dare(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL I =tt - _T • ••LY .
Wayne E. Memmer - Julie A. Memmer _:I 1
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document" —
244 W 3rd St 244 W 3rd St AJ I j 2 2 °21'
Address(Number and Street) . Address(Number and Street) `
Lynnville, IN 47619 Lynnville, IN 47619
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YE • •• • •
0 ❑ 1. Will this property be the buyers primary 0 ❑ 3. Homestead
residence? Provide complete address of primary • 0 4. Solar Energy Heating/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
815 Highland Ave. ❑ 0 6. Hydroelectric Power Device
Address(Number and Street)
Oakland City, IN 47660 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
0 ❑ 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.
244 W. 3rd Street Not available in all counties.)
Address(Number and Street) _I3-Io1 f _QC3I - C _�7
Lynnville, IN 47619 WARRICK (. -I�" V `f Zl�� .J
City Sate ZIP Code County Primary property owner contact name E-mail