HomeMy WebLinkAboutHomestead_Lange INDIANASALES DISCLOSURE FORM SDF ID: - . . . .Page:2
DPP.REPARER:;.. _ :r _ .'•+ k.-•=n.-. _La_ s._.T.h` r_ u72-LICi -.a i-Lacfir,4M ‘ �'i'Ci i." �__kr't:4_e ••
Ray M.Druley Attorney No.4759.26
Prepaier of the Sales Disclosure Form Title
505 N.Church Street, PO Box 146 Law Office of Ray M. Druley
Address(Nuniberand Street) Company
Fort Branch, IN 47648
'Ei:SEEL'ER(S)%GRANT08(S)T2 :,.Ct f.e ,r3 ...-_;' t T¢nit. i a F-7.t _.0,-4.Fri v.-trt. :i 7;il, Midi_, a e
Terry lWallace .
Seller I;Name as appears on conveyance document Seller 2-Name as appears on conveyance document
4361 W 1000 S
Addressplumberand Street) Address(Number and Street) • . . ,
Fort Branch IN 47648• • -
E-mail Telephone Number E-mail
Under penalties of perjury e�eby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and r .plete as req 1 w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature o Seller Signature of Seller
Terry W ace 4/15/19 - -
Printed Name d/Seller Sian Date(MM/DD/YYYI) •Printed Name of Seller . • Sign Date(MM/DO/YYYt)
liSSigTEElq&AP,PLIGATIONtFOR'PROPERTYLITAXDLDUETIONS_.IDENTIFY:AL ITEMS- HAT<APP,L-YI__ _-7 T t
Phillip M Lanoe ) •
I' tj "�
rs on conveyance document Buyer 2-Name as appears on conveyan r{J'n� E A�J�'
505 S. Eighth Ave IL I�Lf 1, •
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 - APR 2 2 20iq
City,State,�ZIP, / '
E-mail Telephone Number 4,484,...a E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE UNTY AUDITOR
YES NO CONDITION YES NO CONDITION E�3355❑✓ ❑ 1.Will this property be the buyer's primary ❑✓ n 3.Homestead
residence? Provide complete address of prim ling/Cooling System
residence,including county:
505 S Eighth Ave ❑ 0 S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
❑ 22.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 ❑ Q 9.Would you like to receive tax statements for this
complete address of residence being vacated, rt1'viae�tra . econtact information
including county: below. Please see instructions for 'n ormation.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code Eoe�ry sic, 13-0G ' _00 '���
\ Primary property owner contact name E-m
•
License/ID/Other Number