HomeMy WebLinkAboutHomestead_Pugh INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
FD<P,REP2IRER � ''� .L- - N-��- z` ent.-- -7`�'.r--•. j -
Elysea M Ledman Settlement&Quality Assurance
Prepare of the Sales Disclosure Form • Tide
3930 Mezzanine Drive, Suite C Columbia Title, Inc.
Address(Number and Street) Company
Lafayette, IN 47905
iE S LbE ER(SyGRAtI'9'DR0P =S�.-ra�,��S g='`���-- � -"'g � -.� �>
Phillip 1 ange Alice I ange '
Seller1'Name asa Bars on conveyance document Seller 2-Name as appears on conveyance document
_SOS cc .N't^- A<'a-P 5°5 `')nt;-t—b. ¶ r. - U
Address(Number and Street) Address(Number and Street) -
kACNO os\-aul ±,,- 10 Le---1 9 Na t)10, r)C C-k ,Z t3 W1 (0 3 )
Email
Under penalties perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge end belief,is true,correct
and complete as ' e by law,-n s prepared in accordance with IC 6-1.1-- 5,"Real
Pro er 1 losure Act".re
Signature of Se er 4} t , Signature of Seller / 17 _�U/-•
Phillip Lan y-5 - 1 By Phillip I amp Co-GuaLdian t 1 - 5'Ipi
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed NamefSeller Stun DatefMMLDb/YYTY)
(F- H A: j.- "'NTE$(S)lAPPliI0ATIO]}'>FQmP_ROEERWiltkXiDEDU,G 10h.iStI DENrIFIFYsi)'L'IITIFF:FIJSpTHAWAPPL
Dusty D. Pugh
Buyer I-Na rson conveyance document Buyer 2-Name as appears on canveya. s - ry {6�
224 South Hart Street 1_.I At A
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 MAY 2 2019
City,State,and ZIP Code City,State,and ZIP Code
E-mail Telephone Number I • E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDE LL OF Tr NTY AUDITOR
YES NO CONDITION NO CONDITION
IA ❑ 1.Will this property be the buyer's primary Q ❑ 3. Homestead
• residence? Provide complete address of primary 4 rgy Heating/Cooling System
residence,including county:
224 South Hart Street ❑ MS.Wind Power Device
Address(Number and Street) ❑ IA 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ }X 2. Does the buyer have a homestead in Indiana to be ❑ El 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ j 9.Would ou like to receive tax statements for this
- complete address of residence being vacated, property via e-mail. ontact information
including county: below. Please see instructions forrI . ormation.
Not available in all counties.)
Address(Number and Street) aio-k2--01-30-2 -D02-- k08 -0
City,State ZIP Cade Coun
' a mper[y ovinerclicaw it
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
Number