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HomeMy WebLinkAboutHomestead_Pio IM IANA SALES DISCLOSURE FORM SDF ID: Page 2 LD:P•REPARER , .a k, c�ti—p 7'-.- - __-� L�e --u:_ n :�ac�:s_- -1 .n�.— LANA C. HARPER _ _ CLOSER Preparer of the Sales Disclosure Form Title 5231 Oak Grove Rd., Ste. A TOTAL TITLE SERVICES. LLC Address(Number and Street) Company EVANSVILLE. IN 47715 812-468-8485 City;State,and ZIP Code Telephone Number E-mail E:�$EL'LER(S)/_GRANTOR(sj-Lar"-.' ' :7- 777:�7 .. :41.-11i��_<� Gary Tillmanns 4 Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document Address(Number and Street) Address(Number and Street) r,ty,State,and ZIP Code City State,and ZIP Code • Telephone Number E-mail Telephone Number E-mail Under penalties of • - jury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete . required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". •Sign ure of Seller Signature of Seller es i MR1211ns Printed Name of Seller Sign Date orm/DD/YYril Printed Name of Seller Ian terMM/DD/ITYY) tF::BUYERN/,GRANTEE(S)_SAP,PCICATIONi _OR:P.ROP.ERTY TAXDEDUCTIONS IDENTIFYtr1L8(fIT Ronnie B. Pio Buyer I•Norte as appeo n conveyance document Buyer 2-Nome as appears on convey document q.% dOlp AL u rr1-7 P,\A Add. (.Number and Sn t) Address(Number and Street) 7Jr tP It-r�^G� : 74, `�it Nt� PooccoR City, E-mail Telephone Number 015O E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES 0 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: r. ❑ Q 5.Wind Power Device Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device ❑ M 7.Geothermal Energy Heating/Cooling Device City,State Zl ode County ❑' 2.Does the buyer have a homestead in Indiana to be ❑ B.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 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) City,State ZIP Code County Primary property owner contact name E-mail • Number License/ID/Other Number INDIANA SALES DISCLOSURE FORM SDF ID: t'' Page 2 ^ 3 D.PREPARER I LANA C.HARPER CLOSER I parer of the Soles Disclosure Farm - Title j 1 _5231 Oak Grove Rd.. Ste-A TOTAL TITLE SERVICES.LIC i Address(Nun her and Street) Company } EVANSVILLE. IN 47715 812-468-84E5 I .;''Wt...and ZIP Caw Telephone Number E.nad I 1 E.SELLERS)/GRANTOR(S) - ' • 1-Gap/Tiemannc 3 jiSell,:T.Narf a s mew Seller 2-Nome as appearsao conveyance data mmf .ieWGn (Suaber an/��//reel) - AdJms:Nom:er and Street -3 C it oua .) Vs}t-e /a SB Penh tsua-/¢ 1 _ Telephone Number ' s &nag I Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct f t and complet D li .and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". I 111 i S+ynatvre of Setter Signature of Seller G"rty Tdlmann4 Pnnted Nome ofSHfer .Sign(bte l4s!flDin T'1 Printed Name of Seller S(ao Derr lux/:.aa»ss F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX i DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY . - t Ronnie 8- Pip j thaw I•Name at upnean on comwnance document Byer 2-Name as appears on rut.eyonre document — 1 .Wcros(:Number and Street) Address(Number and Street? 4n:q end 7,".er I OD'.State and Zip Cale I dtMam Nang, Email i Telephone Number total( i THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. , I YES NO CONDITION � YES NO CONDITION t ❑ 0 1.Will this property be the buyer's primary I 0 0 3.Homestead residence? Provide complete address of pr.• ry ❑ © 4.Solar Energy Heating/Cooling System i residence,including county: 0 0 5.Wind Power Device I 1 :••h/-neINumberandScreet ❑ 0 6.Hydroelectric Power Device -- i Car.GurerlYCade County ❑ 0 7.Geothermal Energy Heating/Cooling Device i 0 [jJ 8.Is this property a residentialrental ? ❑ ❑ -2.Does the buyer - .ve a homestead in Indiana to be property? ITy, i vacated fo is residence? If yes,provide 0 10 9.Would you like to receive tax statements for this ; comp - e address of residence being vacated, property via e-mail?(Provide contact information i i- uding county: below.Please see instructions for more information. Not available in all counties.) n.drns I'amber and Street) I .n:4orc LI•Code County t Primary properry owner contact mane Email Under penalties of perjury,I hereby certify that this Sales Disc re,to the best of my knowledge and belief,is true,correct i and complete as required by law,and is prepared in ac once with IC 6.1.1-5.5,"Real Property Sales Disclosure Act".(Note: 1 Spouse information.Social Security and Driver' nse/Other numbers are not necessary if no Homestead Deduction is being filed-) 1 ' a - rann tare nl Rover; I .Signature of Reyerlft-omr i Permed Legal Nests. :Ter I Sign Late t.Mw/epin»t Printed tgMl•Sarney-Buyer'/Soauie _;�Sian Date i''t't,nm 4 Last digits cfBuyer l Driver's. State Last 5 Digits of Social Seturity Number Last 5 digits of Buyer 2/Spcuse Driver's State Last S O'igrs ofSocat Serum= 2 -sense/ID/Other Number Number License/ID/Other Number