HomeMy WebLinkAboutHomestead_Lloyd (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Jeff Dodson � ----.»TT` - � ----__...�... Closing Agent — -- - -- --
Preparer of the Sales Disclosure Form Title
915 Main St,Suite 304 Dodson Law&Title LLC
Address(Number and Street) Company
Evansville, IN 47708 812-461-6625
City,State and ZIP Code Telephone Number I E-mail
3ESEllaNS11,GRANTOR(S)1 t -- :5_ : _ -
The Secretary of Veterans Affairs
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
City State,and ZIP Code I co;State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury, 1 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".
Signature of Seller Signature of Seller 1I L
Printed Name of Seller Sign Date(Ma/oo/YYYY) Printed Name af Seller ion Date(MM/DD/YYYY)
F BUYER GRANTEEULtAPRINE—TjONTF,OR RROPERTY(,TAXiDEDUCTIONSEIDENTIFYMW.11T MTHAiAP,P,LY; -77
Cody R. Lloyd i'i itrr3
Byer I-Name as appears an conveyance document Buyer 2-Name as appears an conveyance document
114 S Lincoln Ave /-/���}
Address(Number and Street) Address(Number and StreellgSO N C AUDITOR
Oakland City, IN 47660 li OUNT
city,State,and ZIP Code
IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
4a- ❑ 1.Will this property be the buyer's primary Er ❑ 3.Homestead
residence? Provide complete address of primary ❑ ❑j 4.Solar Energy Heating/Cooling System
residence,including ounty:
S ❑ ❑✓ S.Wind Power Device
`ieet rC
Addresfxam/b¢r and fveer) [ ❑ ❑✓ 6.Hydroelectric Power Device
04/r /l4.0 /may /-� �� ❑ ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code ( County
❑ 9-2.Does the buyer have a homestead in Indiana to be El El 8.Is this property a residential rental property?
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
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) R J 4`�3- 0op 007 City,State ZIP Code County 6-IL\ -1 " —�
Primary property ownerc`antact 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
Number License/1D/Other Number
INDIANA SALES DISCLOSURE FORM SDF ID; Page 2
D:PREPARER' - -.-.-._ • - -._-- . - _. _ . . .
• Jeff Dodson Closing Agent - - -- - _ _ :. . _.
Preperer of the Sala Disdorure Form Title
915 Main St, Suite 304 Dodson Law 8 title LLC
Address(Number and Street) Company
' Evansville,IN 47708 812-461-6625
. ' 1
City Smu,and ZIPCode iTelephone Number g ,
mail
The Secretary of Veterans Affairs
Seller I.Nome or appears on conveyance document Seller 2-Nome as appears on conveyance document
810 Vermont Ave NW
Address(Number and Street) I Address(Number and Street)
Washington,DC 20420
E-mail Telephone Number E-mail
Und r penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an complete as required by law,and is Fx'epared ina cordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
i Julia Kolarov
-0 ;>_i ; I id),id), 8 c?-i3 Int
I! SECRETARYFYETERANSAfNURSaAn-0fficer-ouhdUnited
%if•4t8f WINE. By the Secretary's duly authorized property Signature o(Seller
management contractor,Vendor Resource Management, a_I �_I_I_1
P/irbuiPhta:dd *ion of authority found at 38 C.F.R.36.41 Date(M)f/L/Yl'll1 Printed A•amee Seger/ Sian Dote txv/DD/YrrY)
1F BUYER(S)%GRANTEE(S--:AP.PLICATION.FOR;PROPERT:Y:TAX-DEDUCTIONSIDENTI . I St)1 Mr Y-'11 -.. .
Cody R.Lloyd �t
Buyer 1-Name as appears an conveyance document Buyer appearsNameas on conveyanceacumen!acumen!
114 S Lincoln Ave
i Address(NumberandSweet) • Address(Number and Street) FEB 11 2019
Oakland City, IN 47660
C-mall Telephone Number GIBSON et711NTY AI Ir11TOR Email
TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OFT HOSE THAT APPLY.
YES ND CONDITION I YES NO CONDITION
❑✓ 0 1.Will this property be the buyer's primary ❑J ❑ 3.Homestead
residence? Provide complete address of primary ❑ ❑✓ 4.Solar Energy Heating/Cooling System
residence,including county: S.
Wind
Power Device
114 S.Lincoln Ave 0 ❑
Address(Number and Street] ❑ ❑✓ 6.Hydroelectric Power Device
Oakland City,IN 47660 Gibson
City,Scare LP Code County ❑ El7.Geothermal Energy Heating/Cooling Device
❑ ❑J 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 ❑ El 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: balmy.Please see instructions far more information.
Not available in all counties.)
Address(Number and Sheet)
City,State ZIP Code a6 - ILI-18 -4c3 -moo. O07 -907
Count/
Primoryy propertyowner contact name Email
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-S.S,"Real Property Sales Disclosure Act".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.) twig
•[//It,{/'
Signature of Buyer: —"t a Signature ofBuyer2/Spouse
Printed Legal Name of Buyer I Sign Date(R.v/DO/rrrrl Printed Legal Name of Buyer 2/Spouse Sign Dote(vu/DO/Yrn
Last 5 digits of Buyer I Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer 2/Spouse Driver's State Lost 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number