HomeMy WebLinkAboutHomestead_Ziliak (7) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D PREPARER >. _ • .
Britany N Barnes Agent
Preparer of the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc
Address(Number and Street)
E-mail
E.SELLER(S)/GRANTOR(3 •
Matthew G. Oben
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance rim-anent
5049 E 750 S
Address(Number and Street) Address(Number and Street)
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 Signature of Seller
Matthew G.Oben 7-a6, -// _.,
Pr' '.... . Sian Vote Alm/OD/Illl) Prnted Name o Seller \-t Sian Date(Ns1/OD MY)
F.BUYERS ' GRANTEE S -APPLICA . OR PROPERTY TAX )E II II S- I ' ' 91i*Q ,s ' PLY
Andrew D.Ziliak ItM
MA
Royer i-,\'omr as appears on conveyance document Buyer_'-,Ynrnr as appears an.--- rrvanrt docvmrrp y
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Address(Number{7 and Street) Address(Number and Street) d
RA ISr:rttk , TAl W30-1 I, .1pP
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Telephone,'umber E-mail Telephone Number OS3 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPER ' ' HAT APPLY.
YES NO CONDITION YES NO CONDITION
❑✓ ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary 4. .nergy eating/Cooling System
residence,including county: ❑ r.
5156 E SR 168 tp 5.Wind Power Device
Address(Number and Street) ❑ T 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson
❑ 7.Geothermal Energy Heating/Cooling Device
Can;Stat ZIP Code County
❑ _^`\I#f1 2. Does the buyer have a homestead in Indiana to be ❑ B.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 9.Would you like to receive tax statements for this
complete address of residence being vacated, r via e-mar . ct information
including county: below. Please see instructions for more m ation.
Not available in all count ti L
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Address(Number and Street) 1 1—►3-7-00 —on
lint Stare ZIP Cade Count
PT mary property owner contact name E-mail
Number License/ID/Other Number