HomeMy WebLinkAboutHomestead_Barillas INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D. PREPARERs .. .. _ ..., _
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 8124024553 CHRISTINA(aREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
:E.sELLER(s)/GRANTOR(s) , - -
TIMOTHY R WRIGHT s:• s • s :
Seller I-Name as appears on conveyance document Selle • �. y�}4
LO VI 5 -3 pe <SJ.rj 5-c _..: .16.t.
Address(Number and Street) add,- s •mber an,Str e • 1
Under penalties of pe ws y t certify that this Sales Disclosure,to the best of my knowledge acid belief,is true,correct
and co )as uire I •
:�*lFI..' d is prepared in accordant t• IC 6-1.1-5.5,"Real r o• -rty Sales Disci'sure Act".
Signature of Seller Signature of Se I-
: 'id o9/o1/It/- :• : . a 7, , At
Printed Name or Seth Sian Date MM/DD/Y71) Printed Name of Seller Sian Date(MM/DD/YYYn
F BUYER(S)/ ' • V.' E(S) APPLICATION E0-10.0PERTYTAX'DEDUCTIONS IDENTIF,Y;ALL'ITEMS,THATAP.FLY.4 r°`• ' _ter;
MARCO T BARILLAS. II HAYLEE A BARILLAS
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
&j S 3&'/S- log S a•a SI
Address(Number and Street) Address(Number and Street)
J)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE •n T• r' -.-1 s
YES NO CONDITION I YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary YES
3.Homestead SCP 8 Lull
residence? Provide complete address of primary ❑ 151 4.Solar Energy HeatinglCoolin Sy e
residence,including county: ❑
5.Wind Power Dgevircl�� 'Ip'
Address(Number and Street) ❑ 0 6.HydroelectiWPb.4'et B^'e�rICB TY AUDITOR
El] NI ci y sea ezlPCade caanty 7.Geothermal Energy Heating/Cooling Device
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 12 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) a6-t I-I 9r 103 - coo, 7,9s-Da g
MARCO T BARILLAS,II
City,State ZIP Code County
Primary pro perty owner contact name E-mail