Homestead_Lehman INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER .
••
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 bti(dmw.twcbc.com
City,State.and ZIP Code Telephone Number E-mail
•E.SELLER(S)/GRANTOR(S). • • - . •
Kevin Whitehead Jamie Whitehead
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
8453E 450 S 8453E 450 S
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 co plete as required y law,and is prepared in accorda. "with IC 6-1.1-5.5,"Real Property Sales Disclo ure Act".
eliac, 70/1d le(2d a ilk
Signature of Seller It attire of Seller
Kevin Whitehead /'/9-/8 Jamie Whitehead /-/9-/8
Printed Name of Seller Son Date(MM/DO/YYYY) Printed Name of Seller Sign Date(MM/DD/Ym)
F.BUYER(/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT Ai 1- ,
Kirk D L-hm.n __ M-li . • - m.n '��
on conveyance document Buyer 2-Name as appears on conveyance document
10822 Azbury Boulevard 10822 Azbury Boulevard Jai `
Address(Number and Street) Address(Number and Street) 22 2018
� ott
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YCS�—NO —CONENTION,
/ _
❑ ❑ 1.Will this property be the buyer's primary l Z ❑ 3.Homestead)
residence? Provide complete address of primary 7:1----0- 4.Solar Energy Heating/Cooling System
residence,including county: ❑ ❑
8453 E 450 S S.Wind Power Device
Address(Number and Street) ❑ 2 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson ❑ E] 7.Geothermal Energy Heating/Cooling Device
City,State 2 Code County
❑ 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 ❑ 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 -/3 - 33 _ `iD0 - DOD. /4a -coy
City,State ZIP Code County
Primary property owner contact name E-mail