Homestead_Hudson INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2
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D PR_EPARER,...-_
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;SELLS ieV6RANTOR(S1:- . _ • -i .,,,__ •__- - - _ ._ _
William C.Atkins
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10263 F 450 S
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660
City,State,and ZIP Code City,State,and ZIP Code
Telephone Number - 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
and co pl/ettee required'y 1 w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
William C.Atkins (//—3/ Z 0 a 0
Printed Name of Seller _ _ Sign Date(MM'DD/YYYY)__ Printed Name of Seller Sign Date(MM/DD/YYYY)
_F BU, _EI TZE S) APPLIC^ATION FOR PROPERTY TAX,,DEDUCTIONS IDENTIFYALL_ITEMS THAT'APPLY: _ _
'e Ann Hudson
eyance document Buyer 2-Name as appears on conveyance document
5366 S.Jefferson Street t.
Address(Number and Street) Address(Number and Street) c
Oakland City, IN 47660 •t`
City,State,and ZIP Code City,State,and ZIP Code « a,,
( t 1,
S. QC0
Telephone Number E-mail Telephone N .•. 'L E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P's• RTY. IDENTIFY ALL OF TH I\ - .T API Y. \ O
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YES NO CONDITION YES NO CONDITION �a 1141- O•
0 ❑ 1.Will this property be the buyer's primary Z ❑ 3.Homestead ���y
residence? Provide complete address of primary J
residence,including county: 11r��°"_ � - -. ing/\C �ng,9ystem
10263E 450 S ❑ ❑✓ 5.Wind Power Device
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Address(Number and Street) ❑ Z 6.Hydroelectric Power•oevice
Oakland City, IN 47660 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 ❑ I71 9.Would you like to receive tax statements for this
complete address of residence being vacated, pro er via P-mail? Provide contact information
including county: Blow.Please see instructions ore information.
Not available in all counties.)
Address(Number and Street)
aka-0V-Oa- aoa - COD • I`II - nod
City,State ZIP Code County
Primary E-mail
Number License/ID/Other Number
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