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HomeMy WebLinkAboutHomestead_Smith (16) -` INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D:.PREPARERr - �_ — KAREN HARBISON VP Preparer of the Sales Disclosure Form Title 803 E STATE HWY 68 HAUBSTADT STATE BANK Address(Number and Street) Company HAUBSTADT IN 47639 8127685800 kharbison#(a'esbanc.com City,State,and ZIP Code Telephone Number E-mail CORY G SMITH IOHSA A SMITH Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document 1345 W WHEATLAND CT 1345 W WHEATLAND CT Address(Number and Street) Address(Number and Street) HAl IRSTADT IN 47639 HAUBSTADT IN 47639 Under penalties of perjury, I hereby certify that this Sales Disclos e,to the best of my knowledge and belief,is true,correct and complete as rRqu'red y law,and is prepared in accordance viz ,IC 6-1.1.5. e roperty es Disclosure Act". Signature of Sell �/JD /J "Sitn turr`,eooffSe`ller Q CORY G SMITH %/a/..„ 67 7 JOHSA A SMITH ! -a I• / Printed Name of Seller San Da[ µ7M/a0/YYY11 Printed Name of Seller Sian Date(•.M/aa/YYYY) ;E:BUYER(S)/GRA\TEE(St.-APPLIGATIONIEORPROP.ERTI'_TAX,DEDUC--TIONSMDENTIF]''r1bElTEMS THATIAPP..LYL__T TT-. _� JOHSA A SMITH Buyer]-,fame as appears an conveyance document Buyer 2-Name as appears on conve . [ 1345 W WHEATLAND CT aa�gg'•'•,,11 :ED Address(Number and Street) Address(Number and Street) HAUBSTADT IN 47639 THE YES SALES DISCLOSURE CONDITION RM MAY BE USED TO APPL\'FOR CERTAIN DEDUCTIONS FORT I PROPERTY. IDECONDITI ALL OFTHOSE SON COUNTY AUDITOR 0 ❑ 1.Will this property be the buyer's primary 171 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: ❑ / / .F- _, 5.Wind Power Device i •Address(Number and Street) ❑ Q 6.Hydroelectric Power Device HAUBSTADT IN 47639 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 2 2.Does the buyer have a homestead in Indiana to be III 8 Is this proper[ a residential rental property? vacated for this residence? If yes, provide ❑ 2 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) -a. a— (a -8 66. - ooa .3( a-.0.4 city,State ZIP Code county - Primary property owner contact name E-mail