HomeMy WebLinkAboutHomestead_Julian -INDIANA SALES DISCLOSURE FORM SDF ID: 26 19 1127643 Page 2
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Tyler S. Pequignot Escrow Closer
Preparero/the Sales Disclosure Form Tide
375 N. Lincoln Park Title Center of Indiana, LLC
Address(Number and Street)
I
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Stacy A. Emmons - Kendra A. Emmons
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Saes-s-tmtarrrst S%L i, S Inc) E 503a--hince4n-St. Sat i c• 5 / co E
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
E-mail Telephone 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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature ofse/get Sign tare of Seller
Stacy A. Emmons 05/23/2019 Kendra A. Emmons 05/23/2019
Printed Nome ofSeller Sion Date(MM/DLI YYYJ Printed Name of Seller Sian Date(MM/DD/MY)
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n Andrea Lee Kunce
.. n w,con once document Buyer2 Nome as appears an conveyance document
2497 W. 1025 S. 2497 W. 1025 S.
Address(Number and Street) Address(Number and Street) JUN 0 6 2019
Fort Branch, IN 47648 Fort Branch, IN 47648
NTY Al IDITOn'od
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPS• OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
m 0 1.Will this property be the buyer's primary PI ■ t e •.e
residence? Provide complete address of primary ����.�......_;.,,,,ry eating/Cooling System
residence,including county:503 S. Lincoln St. ❑ ❑ S.Wind Power Device
Address(Number and Street) 0 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 26 ❑ m 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ m 2.Does the buyer have a homestead in Indiana to be ❑ m 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, pro a-coal . r tact information
including county: elow.Please see instructions for more ' rmaLion.
eL� Not available in all counties..) L�
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Address(Number and Street) --kg'Act —10 1 �--' 000 . t q ( 02 6
Jar Damienn Julian 1
City,State ZIP Code County
Primary property owner contact name E-mail