HomeMy WebLinkAboutHomestead_Kerns INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Elysea M Ledman Settlement&Quality Assurance
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive, Suite C Columbia Title. Inc.
Address(Number and Street) Company
Lafayette, IN 47905
mail
ESEMH TIS ia�1TlygS 4 � Y -r � �
ram.
Christopher Scott
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
•
428 N Gibson
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
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
a\ 4 \J\L
.complete as required by w,al is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
]� uSignature of S Signature of Seller
Christopher Scott 12/2/2019
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/Ym')
` u _g( ) dtaMt s WK: =V1d1 OaR..>i1PE1 T tkVM'Tta ON I)5 ,tIFrhfi Tt1 "s to P. g*:Jennifer Kerns Kerns Joel Kems
. Buyer 1-Name as appears on onveyance document Buyer 2-Name as appears on conveyance document
213 South Vine Street 213 South Vine Street
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt,IN 47639
fpr. 11 7019 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT AP Y.
YES NO CONDITION ES NO CONDITION
❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead GIBS. COUNTY AUDITOR CB
residence? Provide complete address of prima = - . -•.—�' • - y -. mg/CooliugSystem
residence,including county:
213 South Vine Street ❑ D 5.Wind Power Device
Address(Number and Street) ❑ (I 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El El2.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 ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
be • . •.--• •• '• a c�ions or more
i luding cou ' information.f
� Not available in all counties.
Ad (Numberan�d� C! l
m Y(•1[ e /it1 Lf 7�7:j �/� (,���'� ,f j6-19-31-303-000. 352-009
City,State ZIP ode County
'r owner contact name E-mail