HomeMy WebLinkAboutHomestead_Hallum INDIANA SALES DISCLOSURE FORM SDF ID: Pale 2
D.PRERARER
LANA C. HARPER CLOSER
Preparer o/the,Sales Disclosure Form Title
5231 Oak Grove Rd.. Ste.A TOTAL TITLE SERVICES. LLC
Address(Number and Street) Company
EVANSVILLE. IN 477115
I E-mail
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E.SELLER(S)/GRANTOR'(S),: . . -'. - ...- _. -. - _ . 1_
.Aa4t w W DeHaven Trisha L DeHaven
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ap\c�on coronet down ter, Seller 2-Name as appears on conr,7vnce doe
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AU,-cc(Number and S;rccf) r - Adi ss(,\t her and f cot) +
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E'-mad Telep lone Number 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 co plete as required by law,and is prepared in accordance w th IC 6-1.1-5.5 "Real Property Sales Disclosure Act".
Ki,ir•vuyu5e o .teller 1 Signature al Seller
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, row W DeHaven -� ��� Trisha L DeHaven
Printed Name of Seller Sian Date(MM/no/1'm) Printed Name oler Sian Date(MM/Do/r1111
'F. R S)/CR: 'TEE(S APPLICATION'_-F,OR:PROP,ERTtl.TAX'OEI)UCTIONS`I15E\TIEY+ALI+I1-ED.'1S"THAT;AF?PI:Y `;:t,
Quincy A. Hallum ��
.... �ronver"+cedarument Buyer 2-Name as appears on eomerann ' . it 5-1 IA ��r gg
(dress(\'umberanJ.iitre/e�„, ,' Address(Number and Street)
k •nq (—i �� aJ '-�"1(,[�v APR 8 2019
City,
Telephone Number E-mail Telephone Number � E-mail
THE SALES ISCLOSURE FORM MAY RE USED TO AI'PLYFOR CERTAIN DEDUCTIONS FOR TIIIS PRO : . IDENTCfYTIF��F'1'F{O�+'t�'ON'COUNTY AUDITOR
YES NO CONDITION NO CONDITION
❑ 1.Will this property be the buyer's primary YES ❑ 3. Homestead
residence? Provide complete address of primary . , . o eating/Cooling System
residence,including county:
❑ ❑✓ 5.Wind Power Device
Addre,c(Number and Street) ❑ M 6. Hydroelectric Power Device
❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State LIP .ode County
❑ �J 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 ❑ M 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? Frolic/ contact information
including county: helot' see instructions for mor rotation.
Not available in all counties)
Address(Number and Street)
City;State ZIP Code County
'h-14-18_203-000 ,�-6 L-001- .
✓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