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Homestead_Montgomery (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
eD-PREPARER M -_nt.,--1.ie4 _anatMS -14 ;,. _ z-..:_�.� Sa-• �._ _ a._.11'itSaT
Lelsa Billings Typist
Preparer of the Sales Disclosure Form Title
530 Frederica Street Foreman Watson Land Title
Address(Number cod Street) Company .
•
Owensboro,KY 42301 270-689-2424 LBILLINGSeFW-LT.COM
City,State,and ZIP Code Telephone Number E-mail 1'
EShLIHR(Sj%G RAN TDR(S)_ 1 . a-t-T�. r._._v -:r.-� -- ra- _ _-,,r=-t��,--- �=eez-r'i
Jagoe Homes Inc
Seller1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document •
3674 Wa'hens Crossing
Address(Number and Street) Address(Number and Street)
•
-
U•der •enalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a c• plete a r quired by aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
a
iii J L '
Signature of Seller
MEIN 41
Printed Name ofSeller Sion D re DOD 'I Printed Name of Seller Sign Date(sat/oc
-F4:BUYER(S)J GRANTEE(SAPPLICATIONFOR'4PR4PE• Y_TA%DEDUCTIONS,`-'IDENTIRSALIYITEMSiTHAT-APPL ==y
Kimberly Montoomery -A
Buyer l-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document •
1436 West Chukar Hollow Road
Address(Number and Street) Address(Number and Street) Oe ?
Haubstadt, IN 47639 - (•C a .
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTALN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.4t<
YES NO CONDITION I YES NO CONDITION y'
V1 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead v�//.
residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System 4) 4 ,
residence,including county: ❑ , 5.Wind Power Device 5 ∎1J
Address(Number and Street) ❑ [✓I 6.Hydroelectric Power Device I
❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County
❑ [f 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 ❑ [ 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) 02 4_1 g'_3& _ 300 - o0a. 9I 1-Dau
City,State ZIP Code County
Primary property owner contact name E-mail
•
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
;D.,P,REPARER_ r `E aa. = z a _. _._ =
Leisa Billings Typist
Preporeraf the Sala Disclosure Form ntle
530 Frederica Street Foreman Watson Land Title
- Address(Number and Street) Company
Cwensbaro,KY 42301 270-689-2424 LBILLINGSeFW-LT.COM
Clry,State,and ZIP Code Telephone Number E-mail
r .� -'mot - -,wr °`- ". x sa. .z �-�--•^
?ESELLER(S)/GRAVT'flR(S) � = .__�..�:�_ _ ._.�-� _�.t_: �' � x i � .� -�.� ���
Jago=Homes Inc
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3974 Wa'hens Crossing -Address(Number and Street) Address(Number and Street)
Owensboro
de. tenalties ,f perjury,I ereby certify that this Sales Disclosure,to the best ofmyknowl�: geSanthb is e - ,correct
• •• r co lete as I'quir d by aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Pro files DISC;'. —ct".
e� / ' S19namre of Seller e5'Q N Q
Printed Name Seller Sian Date xN/o1444,1 Printed Nome of Seller '.-W SLn Date Si onaw
:F.BUYER(S)JGRANTEE(S)'!'ApP,Me TION FOR RTYzTAX DEDUCTIONS,:IDENTIFY ALI)TCMS'F t.a PPLY- -;.c T y,_Y. _
Carl N.Ball.Jr. Cheryl Ball /TO,q
:ter' 4':lne Errorsat conveyance c cuumme�ct� /� a'z' -P.in a appears pnc n� dam .• _
cha ,u /bx^ l/ 21L1 ,
l :A A r A
d• a ,vmbe and Street) A d " �
— -
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ ❑ 1.Will this property be the buyer's primary (7] ❑ 3.Homestead
residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0 5.Wind Power Device
Address(Number and Street) ❑ V] 6.Hydroelectric Power Device
❑ IA 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Cade Caarty
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ [ 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)
d‘-i7 it- 360- elan. -7 / 775.05Y
Cly,State ZIP Code Cauc y
- Primary property owner contact name E-mail