HomeMy WebLinkAboutHomestead_Heath INDIANA SALES DISCLOSURE FORM SDP ID: Page 2
D.PREPARER ;•
LANA C. HARPER CLOSER
Preparer of the Sales Disclosure Form Title
5231 Oak Grove Rd., Ste. A TOTAL TITLE SERVICES, LLC
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-468-8485
City,State,and 7JP Code Telephone Number E-mail
E.SELLER S)/GRANTOR(S) _
Robert A Leary
Seller I-Name us ap on comer dacumen j n Seller 2-Name as appears on conveyance document
110 3b DN ily'
7 s(Number and Str t) Address(Number and Street)
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
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and • : plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Ali . 1
Signature of Seller Signature of Seller
Robert A Leary
Printed Name of-Seger Sian Date(MM/DD/YITT) Printed Name of Seller Sian Date WMI/DO/1Y1Y)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY.TAXDEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY .
--/Cdrea C. Heath Jane E. Snyder
.."rs on an`eyanncct decam
Buyer 2 Name as a po m veyance dot eat
Ir 11 G`
ddress(Numberand Skeet) Address(Number and SO- t
O Wen 5Ui .`e ZN 41 c5 /
YES NO CONDITION YES rnvn ON
�❑ 1.Will this property be the buyer's primary 3.Homestead DEC 2 8 2017
residence? Provide complete address of primary 0 4.solar Energy Heating//C,/ooling System
residence,including county: ❑ 0 5.Wind Power Device Y� 1,
Address(Number and Street) ❑ Fl 6.Hydroelectric P1 P QiEWNT�Y AUDITOR
❑ Fl 7.Geothermal Energy Heating/Cooling Device
City,State ZIP.ode County
❑ 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 n Fl 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 . ---
City,State ZIP Code County 17- Id. - 0)-0 A -zoo 2.-
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Primary property owner contact name E-mail