HomeMy WebLinkAboutHomestead_Anderson (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Timothy Shea Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
+ -`-�. mod.'.z.- _..f- f
Stephanie M.Bengert
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
204 N 3rd Street
Address(Number and Street) Address(Number and Street)
Owensville,IN 47665
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
an o pl to as re uire by law • repared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
S ature ofSeller Signature ofSeller
Stephanie M.Bengert JD OV20/7
Prin Sign Dat /DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
AlRABiIYER'(SrlditAIgta(:-S')..:9`.PP'I;ICAtRIONaFORVPROFERTY:T}AX;:DEDUCy t-01 S._IDEWMP ALLslatici `PHATAAPIY
Andrew Lee Anderson Jamie Lynn Anderson
-Bayer i-,vame as-appear conveyance document Buyer 2-Name as appears on conveyance document
9-96 c,) 300 S ` 5aa/lk2
Address(Number and Street) Ada ess(Number and Street)
aeilsvi((!r t(") L(7(C5- (.57t1A
Telephone Number -mall
Out 11 2019 •
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP.. :ENT OF THOSE THAT APP
YES NO CONDITION YES NO CONDITION
Lai ❑ 1.Will this property be the buyer's primary �❑ 3.Homestead GIBSO OUNTY AUDITOR CB
residence? Provide complete address of prima lar Energy Heatin oling System
residence,including county: ❑ Q 5.Wind Power Device
204 N Third Street
Address(Number and Street) E El 6.Hydroelectric Power Device
Owensville,IN 47665 Gibson ❑ 10 .7.Geothermal Energy Heating/Cooling Device
V,City tate ZIP Code County ❑ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
complete address of residence being vacated, r e-mail?(Provide contact information
including county: below.Please see ins ' s or more information.
Not available in all counties.)
Address(Number and Street) 26-17-01-404-OOQ. 104-022
Andrew Lee Anderson Jamie Lynn Anderson d6(k.
City,State ZIP Code County Primary property owner contact name f E-mail