HomeMy WebLinkAboutHomestead_Hudson INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER .
Crystal Libbert Title Clerk
Preparer of the Soles Disclosure Form Title
4703 Theatre Dr. Regional Land Title
Address(Number and Street) Company
Evansville, IN 47715 812-402-4553 crvstalereoional-Lt.com
City,State,and ZIPCade Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
Daniel W.O'Neal
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
-`l)ns,r/ uI_ tYJF4 (,
Address(Number and Street) Address(Number and Street)
7OR S ,STn,A11ne )rsr.
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c plete as equired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Daniel W O'Neal /u/d//1
Printed Name of Seller Sign Date(MM/DD/YiYY) Printed Name of Seller . Sign Date(MB/DIMITY)
F.B_,;,,,, .GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY .
Zachary S. Hudson
. .ppears on conveyance document Buyer 2-Name as appears on cony once cu e J
.SU( S 3t-C-ccrs<... S4-
•Address(Number and Street) Address(Number and Street) DEC 28 2017
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THE SAL ISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION 1.. YEC N-0 C'ONi• e
lc( ❑ 1.Will this property be the buyer's primary i 0 (11 3.Homesteae
residence? Provide complete address of primary . • rA •, , • - - -eating/Cooling System
residence,including county: ❑
5366 S Jefferson St 5.Wind Power Device
Address(Number Street) ❑ 0 6. Hydroelectric Power Device
Oakland Ci IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State Code County
0 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 ❑ 0 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)
a6 - 020 -OA - goy -000 . /0? -003
City,State ZIP Code County
Primary property owner contact name E-mail