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HomeMy WebLinkAboutHomestead_Hughes INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 DaRREPARER I Kandace Rogers Closer Preparer of the Sales Disclosure Form Title 3101 N. Green River Road Suite 130 Columbia Title Address(Number and Street) Company Evansville IN47715 812-471-8563 kandaceno,columbiatitlegroup.com City,State,and ZIP Code Telephone Number E-mail E.SELIIKS)%GWANIOR(S) -. . — — — — - I Allen C Perkins Revocable Trust Seller 1-Name as appfarsol convewe doc merit co Seller2-Name as appears on conveyance document AdNu and Street) Address(Number and Street) `���I 'Number ?t ) -170N E-mail Telephone Number E-mail Under penalties of perjury,I hereby • - ,:athatlf. . es Disclosure,to the best of my knowledge and belief,is true,correct and coin T •to as required b • ,and iistdro ed in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". i Sig' a Seller fa /" Signature of Seller -••. : •-rkins Siu PSSnr Trustee 2/8/2019 Printed Nr e of Seller Sign Date(MM/DD/YYYt) Printed Name of Seller Sian Date MAI nD F.BUt' R(S)%GR'ANT�EE(Sj_,/AP,RUICAT�IONIEQRIP,ROPERT,YTAXADEDUCTIONS IDEHIFIF11rACL;IT)n . to1il 1'-, _ _ _ �_ Chelsi J.-Hughes t Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 606 E Ulen St FEB 1 9 2019 Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 City,State,and ZIP Code City,State,and ZIP Code E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead residence? Provide complete address of primary ❑ ❑✓ 4.Solar Energy Heating/Cooling System residence,including county: 606 E Ulen St Ill ❑✓ 5.Wind Power Device Address(Number and Street) ❑ Q 6. Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ 1l 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ N 2. Does the buyer have a homestead in Indiana to be ❑ II 8. 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. INot available in all counties.) Address(Number and Street) ./yam)_//� yt� (�/7 Citx State ZIP Code County &b—I C-18- 2b — ©w- ?33 -O 4 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