Loading...
HomeMy WebLinkAboutHomestead_Jones INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 LD?iPLREBARERf _'_---"-r . -s. . . . Tim D. Mason Broker Prepare,of the Sales Disclosure Form Title 106 S Fifth Ave RE/MAX Midwest Real Estate Address(Number and Street) Company Princeton,IN_47670 812-66-0845 timmason(o)remax.net City,State,and ZIP Code Telephone Number E-mail E.:SELI:ER(S)'/,GRANTaaR(S- ))___—' . ._ . , , s; - ,.- . ,<_ ..< _ Mid-West Development Inc Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document • 106 S Fifth Ave Address(Number and Street) Address(Number and Street) 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 bylaw`and is re pared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". �n ire o fSef/e/re2.1l /y/I/nL /g/)' '_ l (- Signature of Seller 714 //. .ic-CO 71 1-75 , ,_1 Printed Name of Seller Sign Date( M/OD Printed Name of Seller Sian Date(MM/DD/YYYY) [FZBU;YER(S)'/GRANTEE(S) ;+AP,RLICATIONjEORI@RQ$ERIVi=TAX¢QE_D UGTIQNSIDENATI_Falr11'ALLIITjEMSFTHATtAPP,LY _ > ° .. Janelle A.Jones _ Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance d en 8496 E State Road 168 Address(Number and Street) Address(Number and Street) D a,( Oakland LU - THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THA'1"�PLYr,. YES NO CONDITION YES NO CONDITION ✓C rt? 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 8496 E State Road 168 ❑ Fl 5.Wind Power Device Address(Number and Street) ❑ IA 6.Hydroelectric Power Device Oakland City, IN 47660 Gibson ❑ f 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ El 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 ❑ El 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) � / / City,State ZIP Code f7E��U /v'boa- 6D/ 71-d°/ County Primary property owner contact name E-mail