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HomeMy WebLinkAboutHomestead_Smith (6) INDIANA SALES DISCLOSURE FORM ' SDF ID: Page 2 D.PREPARER - • = • • _ _:_-:_._. ._ Leon C. Stone President Preparer of the Sales Disclosure Form Title 226 West Broadway Street Broadway Title, Inc. Address(Number and Street) Company Princeton, IN 47670 ( E-mail E SELLER(S)/GRANTOR(S)' _ . ' _ — - .— - David L Cooper Trustee Terri L Cooper, Trustee Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 9870 F 550 S 9870 F 550 S Address(Number and Street) Address(Number and Street) Oakland City_IN 47660 Oakland City, IN 47660 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". 10.4_4.i-t....(4)CI' O1.e.)-c-) 4-4A-(-2- ( e_ a i,--,,--6)52.-d Signature of Seller U Signature of Seller r avid L.Cooper.Trustee • /OA 7/// Terri L. Cooper. Trustee 1 19/mod 19 Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F.BUYER(S)/GRANTEE(S) APPLICATION FORPR OP. ERTY TAX,DEDUCTIONS_IDENTIFY ALL ITEMS_THAT'APPLY': _ • Matthew_E._Smith- .: _ -, Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on co c o ent ra 209 South Third Street Address(Number and Street) .. Address(Number and Street) Francisco, IN 47649 c•\ ' ® 7. \ E-mail Telephone Number oq E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THOir...k . NTY AVC YES NO CONDITION YES NO CONDITION GI,.., ❑ 1.Will this property be the buyer's primary [^'n 3,Homestead I residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 9870E 550 S El ❑✓ S.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Oakland City, IN 47660 Gibson ❑ Z 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ ❑✓ 8•Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Z 9.Would you like to receive tax statements for this 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) ------ —I Lz -10a-3aio-ice. Ia3= =1=-= License/ID/Other Number 1