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HomeMy WebLinkAboutHomestead_Cook (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Leon C.Stone President Preparer of the Sales Disclonte Form Title 226 West Broadway Street Broadway Title, Inc. Addrass(Number and Sweet) Company Princeton, IN 47670 (812)386-1687 bti(Tmw.twcbc.com City,State,and ZIP Code Telephone Number Email ESELL•IiR(S)'/.GRANTOI2 IS)`- ' ` 8 a Secretary of Housing&l Irhan Development Seller I-Naamm^er�assaappears on conveyance ydocument Seller 2-Name as appears an conveyance document 4/ Crrfi d ers(A'vmberand Street) Address(Number and Street) kTC vi\ G-4- 3D3D3 City,State,and ZIP Code( City,State,and ZIP Code Telephone Number E-mail Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct n co plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". sign° nofsteei3Shaunda \Nrig Signature of Seller Panted Name of Seller - b`- Slat Date(MM/DD/YYYII Printed Name of Seller T7 i . to(MM/DD/n111 YES NO CONDITION 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: 0 0 5.Wind Power Device 303 N Diviainn Street Address(Number and Sweet) 0 0 6.Hydroelectric Power Device Francisco,IN 47649 Gibson 0 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ID0 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 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) c),6-13—\-1- 10& —DOD t)z—QDr City State ZIP Code County Primary property owner contact name E-mail Number License/ID/Other Number