Loading...
HomeMy WebLinkAboutHomestead_Shultz INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 OlfEREP,ARERi' — _. 414: _-.��,.:<-.X , - . 7a1 - _—:' .. .-;# aYr `. ITC7 v. Leon C. Stone President Preparer of the Sales Disclosure Form Title 226 West Broadway Street Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 (812)386-1687 btiemw.twcbc.com City,State,and ZIP Code Telephone Number E-mail tE?SE6LER(S')7XGRANrIFGR(S)€',:� , -_ 4. : 1 • S A Weiss I LC Seller l-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 307 E Vine Street Address(Number and Street) Address(Number and Street) Ft Branch IN 47648 Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as required by I. w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". S. A lf�-e0 / MRER. Signature of Seller Signature of Seller Steven A WPISC /0627/17 Printed Name ofSeller Sian e(MO/YYYYI Printed Name of Seller Sian Date(MM/DD/YYYY] iP,I laW IT R(S)}/.GR:ANTEEMI:a:APPL•(CMil0N F,OORFteRE1311 TAXspEMKT 10N5_;IDENiT1EY;ALCiITEMS TI-EAID IRDY, ".,i . .- = F- 2 Kevin M. Shultz Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 401 N Hull Street • Address(Number and Street) Address(Number and Street) Ft. Branch, IN 47648 � THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY, IDENTIFY ALL OF THOSETIU Illr YES NO CONDITION YES NO CONDITION °C/ 'lbj% , ❑ ❑ 1.Will this property be the buyer's primary IL ❑ 3. Homestead rtii/Df residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System-R residence,including county: ❑ S.Wind Power Device 401 N Hull Street Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Ft. Branch, IN 47648 Gibson ❑ 17l 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ID 17] 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 ❑ 171 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. /9-/_ 30a- J60. ,f/-6A6 City,State ZIP Code County Primary property owner contact name E-mail