HomeMy WebLinkAboutHomestead_Smith (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:'PREPARER: - -7,` ;_• • ' ""' `4-Acv,
KAREN HARBISON VP
Preparer of the Sales Disclosure Form Title
803 E STATE RD 68 THE HAUBSTADT STATE BANK
Address(Number and Street) Company
HAUBSTADT IN 47639
SCOTT A ROBISON
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
7533 SAINT JOSFPH COURT
Address(Number and Street) Address(Number and Street)
NFWBURGH IN 47639
City,State,and ZIP Code City,State,and ZIP Code
E-mail Telephone Number
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 requiztd by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
SCOTT A ROBISON 09/27/2019
Printed Name of Seller Shin Date(MM/DD/YYYY) Printed Name o Seller Sign DateiMM/DD/YYYY)
S APPLICATIZON POlk-P.ROPERTY TAX DEDUCTIONS IDENTIVYALL IISNBli-IAT APPLY,'
ORY G SMITH
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Buyer 1-Name as a on co eyance document Buyer 2-Name as appears on conve nc d um t
ATLAND CT j
Address(Number and Street) Address(Number and Street)
HAUBSTADT IN 47639
City,State,and ZIP Code City,State,and ZIP Code OCT 1 2019
MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERT F THOSE T
YES NO CONDITION NO CONDITION G ON COUNTY AUDITOR
Ei 1.Will this property be the buyer's primary [7] 3.Homestead
residence? Provide complete address of primary ating/Cooling System
residence,including county:
El 5.Wind Power Device
420 S WEST ST
Address(Number and Street) 6.Hydroelectric Power Device
HAUBSTADT IN 47639 GIBSON 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 El 8.Is this property a residential rental property?
2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 111 I71 9.Would you like to receive tax statements for this
complete address of residence being vacated, proper via-e-trraittrrovide.- ntact information
including county: w.Please see instructions for mo ormation.
Not available in all counties.)
Address(Number and Street)
D,6 a3-06 -2)oi - o 00. 31 L -o
City,State ZIP Code County
Primary p"Mpyrty owner contact name E-mail
Number License/ID/Other Number