HomeMy WebLinkAboutHomestead_Fleming INDIANA SALES DISCLOSURE FORM SDF ID: Pale 2
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Kandace Rogers Closer
Prsporer of the Sales Disclosure Form Title
3101 N.Green River Road Suite 130 Columbia Title
Address(Number and Street) Company
Evansville, IN 47715 812-471-8563 kandace(acolumbiatitlearouD.com
City,State,and ZIP Code Telephone Number E-mall
ELL'ER(STAMNTORISJ r=e nz* ::._ — -,- 5 . -" - '---- -
Kevin,l Fleming
SellerI-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
„2/9 S, Rucft
! Address(Number and Street) Address(Number and Street)
PciaLL 5174' 'R)
certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comple as •eq tired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature feller r 1 - Signature of Seller
Kevin.I Fleming v ) Z .-7 - Zv)g
Printed Name of Seller Sign Date(MM/DD/YFTY) Printed Name of Seller Sign DatfMM/DD/YYn)
RSU:YE itg1dRIiNTEE( ' PP,LICt1TI0 T O PtgeBERTaY'PAXDED ell0N$ ?1DEISird )AL=L I i 'A_ ,Et
Angela D. a
Fleming
Buyer Name as appears an conveyance document Buyer Name as appears on conveys doer/silent
305 East Plum Street (err 3 1 7m8
Address(Number and Street) Address(Number and Street) Ut= , -
Haubstadt, IN 47639
TO APPI.Y FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION I
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:
305 Fast Plum Street ❑ 05.Wind Power Device
Address(Number and Street) 0 0 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
DI [ ' 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 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)
r-36 - I q-c31-3b4- too r2-7D - oocP
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
Number Licence/in/Other Numhor