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HomeMy WebLinkAboutHomestead_Cincirpini INDIANA SALES DISCLOSURE FORM SDFID: Page2 j.D?iP,RERARER -� '177f-‘-'7..r.--7-rr T - T_ *— _� Deena Hendrickson Closing Services 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 closings(rhreeionaltitlellcom City,State,and ZIP Code Telephone Number E-mail Andrew McClanahan Seller]-Name as appears on conveyance document Seller I-Name as appears on conveyance document 604 S Lincoln Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 . 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 and co plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Mynatur Seller Signature of Seller Andrew McClanahan 117 I r/ 1] Printed Name of Seller I DateIMM/DD/YYYF) Printed Name of Seller Sign Date(MM/PD/YYYY) LF. RUYER(SWGRAN,,TiEEIS)WABP.L'ICATIONlEORERROP-ERWILITAXtDEDUGTiIONSJIDENTIEWALMIFEMSnTiHAVARP.LYP.---- - -- - - Justin T. Cincirpini Jessica N. Cincirpini Buyer]-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1301 5 200\V 1301 5 200 \V Address(Number and Sweet) Address(Number and Street) Princeton, IN 47670 Princeton, IN 47670 mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT en. - YES /0 CONDITION /YES /NO CONDITION `S Er 1.Will this property be the buyer's primary !K ❑ 3. Homestead residence? Provide complete address of primary ❑ El 4.Solar Energy Heating/[.�ob11C lc n3SP residence,including county: ❑ El 5.Wind Power Device 604 S Lincoln �[ — Address(Number and Street) ❑ Ei 6. Hydroelectric Power Et aea- {; Fort Branch, IN 47648 Gibson ❑ �El-,/a J�.Geothermal En �3 attiflgf1 o(fnaInt -daR Ciry,Statea County ❑ L� -Is this property a residential rental property? ❑ 2.Does the buyer have a homestead in Indiana to be ❑ El 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 ncluding county: below. Please see instructions for more information. iNot a( DOD e in all counties.)n Address(Number and Street) (Q I (,9-1 q-jo I- .�v 1 eQft, Justin T. uincirpini Jessica N.Cincirpini City,State ZIP Code County Primary property owner contact name E-mail Under penalties of perjury,(hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct