HomeMy WebLinkAboutHomestead_Lee (9) INDIANA SALES DISCLOSURE FORM SDFID: Paget
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Jennifer Wade Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (812)759-5555 closines(tilreeionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
Christopher A. Shoulis
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
914 S Stormont St
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
]tote,ana al"Cade ]
E-mail
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 by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
Christopher A. Shoults s131/12.01g
Printed Name of Seller Sign Date(MM in) Printed Name of Seller ,V0
Printed Sign Date(MM/DO/YYYY)
EJBU:YER(SI7/GRAN,TEE(S AP.BBIGATION1EORiRROP-ERT,yaTAXIDEDUE-TIONS' (IDENTIEWALtEstITENISiTHAVA °WAWc _ I
Zachary Keith Lee 4 ,y�r"No
Buyer 1-Nome as appears on conveyance document Buyer 2-Name as appears on conveyance document
8055 W 400 S P/n� /�
Address(Number and Street) Address(Number and Street) 9O
Owensville, IN 47.665 No/'
"• - •
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
Y�ES.(, NO CONDITION Y NO CONDITION
�J ❑ 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: ❑
914 S Stormont St MI 5.Wind Power Device
Address(Number and Street) ❑ O 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ p 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 8. Is this property a residential rental property?
❑ u�
2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
ncluding county: below. Please see instructions for more information.
Not available in all counties.) n �'y�)
Address(A'umberand Street) Zachary Keith Lee,96•-is-1a-x -cn2 / 7Lt
City,State ZIP Code County Primary property owner contact name E-mail
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 by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". (Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
bein! led.)
Signature of Buyers (( Signature ofBuyer2/Spouse
Zachary Keith Lee —��
Printed Legal Name of Buyer l Sign Date(MM/DD/nn) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YYYY)
Last 5 Digits of Social Security
License/ID/OtherNumber Number License/ID/Other Number