HomeMy WebLinkAboutHomestead_Gipson (2) INDIANA'SALES DISCLOSURE FORM SDF ID: S Page 2
bD*PREPARER YF _ '. ar•. • P, a• ;?",' . ^„. a^t"S-'-, ` r fi
1
Ruth Horton Closer
Preparer of the Sales Disclosure Form Tide
' 7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville,IN 47715 (812)759-5555 closines(ahreeionaltitlellcom
City,State,and ZIP Code - Telephone Number _ E-mail
' •Clinton D. Leek
Seller I-Name as appears an conveyance document Seller I-Name as appears on conveyance document
9626 W Winyard Place 9626 W Winyard Place
Address(Number and Sweet) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co i let• as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/ ; . a
Sign•'e'I er e Signature of Seller
Clinton D. Leek 6.207/zo/p
Printed Name of Seller Sign Date(aa(/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/Mr)
(tE§BU.YER(SWG—RRANTEE(S)WATPLrIGAT10NYFORIP.R0RERTWa7?AX DEDU01110 (DENTIFNEALffITEMSa Thai ARPRY -4 ". -'_ l M
Richard K.Gipson 1 f;4-+c.n - ti a
Buyerl-Name as appears on conveyance document Buyer 2-Name as appea on conveyance document
6616 W 450 S ry�,Q NO11CliVe A1Nf100��N[GSBIO
Address(Number and Street) ress(NumberandStreet) +yl j�
Owensville, IN 476651 /�
THE SAW DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF TH t;C. T .'t Y. j j
YES NO CONDITION YES NO CONDITION ( _]
.
❑ 1.Will this property be the buyer's primary (� ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county:
❑9626 Winyard Place MAY 1 6 2018
0 5.Wind Power Device
. Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ 8/� Geothermal Energy • Device
City,State ZIPCode County ❑ N .Is this proper(ylaBetddd8trlMgtl il9FOR ?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
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- /1-�(- ao o- 005-: 191-oa/
Richard K. Gipson and Brittany Gipson
City,State ZIP Code County Primary property owner contact name E-mail