HomeMy WebLinkAboutHomestead_Conner INDIANA SALES DISCLOSURE FORM SDF ID: Paje 2
D:PREPARER
Britany N Barnes Agent
Preparer of the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc
Address(Number and Street) Company
Princeton, IN 47670
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S GRANTORS _ __
Mike A Gomez
Seller I-Nome as appears on conveyance document Seller 2-Name as appears on conveyance document
628 W Walnut
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
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
and_co plete as requ' ed by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
7- y �
Mike A Gomez f a
Printed Name o Seller .Si,n Date(MM/DD/YYYn Printed Name o[eller _ Sian Date(MM/DD/YYYY)
UYER(S)/GRA (S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Ronald� E Conner .
JetrEi —
�7scrme rr,,ggreurs o� n'conveyance document Buyer 2-Name as appears on conveyanc mem/reef- r- ,
17616 E 850 I a
II J
Address(Number and Street) Address(Number and Street) ar
Mount Carmel, IL 62863
mail Telephone Number _E-mail
THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TIlIS PRO ' , DENTIPY A •' OSE THAT A Y
YES NO CONDITION YES NO CONDITION GI ON COUNTY AUDITOR
❑ ❑✓ 1,Will this property be the buyer's primary in/ ❑ 3,Homestead
residence? Provide complete address of primary eating/Cooling System
residence,including county: ❑ 0 5,Wind Power Device
628 W Walnut
Address(Number and Street) ❑ ❑✓ 6,Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 7,Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 02,Does the buyer have a homestead in Indiana to be 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ ❑✓ 9.Would you like to receive tax statements for this
complete address of residence being vacated, r ' ' rovide contact information
l including county: below.Please see instructions Tore information.
Not available in all counties.)
Address(Number and Street)
26--12-07 to I -0 07- olb-028
City.State ZIP Code County
Printery property owner contact name E-mail
Number Licenso/ID/OtlterNumber
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