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HomeMy WebLinkAboutHomestead_Cox (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 h, P,REAE _ .�s x -'rr.>to Y.rt—sti gx w - c_>a:�:F , -.-^tettvA_-'ar c ^ _ .�_.. Lynette Murray Processor Preparer of the Sales Disclosure Form Title 2301 N Burkhardt Rd First Advantage Title Address(Number and Street) Company Evansville. IN 47715 I 812-490-8485 I theteam(&irstadvantagetitle.com City,State,and ZIP Code iTelephone Number Eanail tE?SELLER(S)/GRAN:T,ORWi , ' ->S_:77-7:1" _ -1 7fl , ,-- `- ; _ ' - Mission Real Fstate Grouo Inc Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document J C 4evvaS LAI (7 Uthrere_ Address(Number and Street) I Address(Number and Street) j n J�oN s4/3 0( Ns;rLl1e i y725 Email Telephone Number E-mail - Under penalties of perjury, pppeerjury,I ereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct /xa and comp t iced oi / I ,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". ' ) Printed Name of Seller Sian Date(MM/DD/Ymt 1 Ft;BU,YER(5)%GRAN:TEE{S)ti1RPl ICATION'FORtPROP;ERTYi rWliwDU.CIIioNSgIDFNP,IFYALL'iITIEMsiTHAVAPP,LY_a 7 _ Bonnie R Cox er B ] Nvme�ppears on ranvrytt an data eN Buyer Name as appears on cac�x yen , D Address( mrntrr Address(Number and Street) FEB 18 2of+4be5r �L. G3I City E-mail Telephone Number r/it In(r( AUDITOR E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OFann tENH war-APPLY. YES NO CONDITION I YES NO CONDITION to ❑ 1.Will this property be the buyer's primary Q/❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar-Energy Heating/Cooling System �/ e idenc ncludingcounty: cR / fna,1yi ❑ ❑✓ S.Wind Power Device Addres-r'yumbel and Street(' // i 11'' 11 Jr < ❑ 0 6.Hydroelectric Power Device V (,1MiY�SVI 1 (-p f �1V mil"7U(L ... ❑ ❑ 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 2 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Z 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) t''I � City.State ZIP Code County b-ti -01 - Li "1 - 000 ��1� 2_a_ 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 License/ID/Other Number