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HomeMy WebLinkAboutHomestead_Randolph INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 d1 _ z , D P1125A R J s Rexanne McCauley Title&Escrow Processing Preparer of the Sales Disclosure Form Title 3930 Mezzanine Drive, Ste C Columbia Title, Inc. Address(Number and Street) fE SELLER(S)/GRANTOR 5111 ... Richard F. Greenwell Seller 1-Name as appears on conveyance document Diana M. Denbo i 9Seller 2-Name as appears on conveyance document alp IS E C1 a,Ss CC;_ 0�- 1630 Horseshoe Falls Addre s(Numberand Street) , Address(Number and Street) t—�C'�U, E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my owledge and belief,is true,correct and complete as required by law,and is p epred in accordance with I 6- . 5,"R P o�perty Sales Disclosure Act". Signature of Seller S nature of Seller Richard E. Greenwell 9/26/2019 Diana M. Denbo 9/26/2019 Printed Name of Seller I Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F BUYER(S)/GRANTEE(S) :APPLICATION_FOR PROPERTY TAXDEDUCTIONSIDENTIFYALL_ITEMS THAT APPLY• _ ` _ __ I. i Blake_M.Randolph i' Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 117 West Glendale Street Address(Number and Street) Address(Number and Street) Princeton, IN 47670 City,State,and ZIP Code I City,State,and ZIP Code I E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION WI ❑ 1.Will this property be the buyer's primary LZ_ _Q-3._Homestead 1 residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 117 West Glendale Street ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ E 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,SIP Code 1County ❑ 2.Does the buyer have a homestead in Indiana to be ❑ ❑✓ 8.Is this property a residential rental property? ❑ z 9.Would you like to receive tax statements for this vacated for this residence? If yes,provide complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. Not available in all counties.) Address(Number and Street) n_ i+ ilAL___•,, .,___-_ City,State ZIP Code County E. ZT-12�0���?) L62 -7-91-aOZ9 Primary property owner contact name E-mail