HomeMy WebLinkAboutHomestead_Pinnick INDIANA SALES DISCLOSURE FORM SDF ID: Page
ti 1'REPARER . ._r .. ._., _, ....... _ r
MaRTARNM
Elvsea M Ledman Title&Escrow Processor
Preparer of the Saks Disclosure Form Title
3930 Mezzanine Drive,Suite C Columbia Title,inc.
Address(Number and Street) Company
Lafayette, IN 47905
MSJ Fnterprises I I C
Seller 1-Name as appears on conveyance document Seiler2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
Ciry,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 complete as required by law,and is prepared in accordance with IC 6-1.1-5,5,"Real Property Sales Disclosure Act".
Signature ofSeller Signature ofSeller
By:John D.Albers,Member
Printed Name of Seller Sin Date(Mj/DD YYYI) Printed Name ofSeller Sign Dare(MM/DD/YVYYJ
BUYER atEE f 1P LICAfi,ON#1 OAT PA`I'3Tfill I2ED-i7l fI -1D I1T,l t*LUIT.1tS.N_1S FT 1T'A,Pl'l
Kevin Pinnick
ars on conveyance document Buyer 2-Name as appears on conveyance document
Ad ress(Number and Street) Address(Number and Street)
(7( toC FILED
Clty,Stag,and ZIP Code CO;State,and ZIP Code
E-mail Telephone Number Email
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THiS PROPERTY.IDENTIFY ALL OF THOSE THAT APPDAviLligit—
YES NO CONDITION YES CONDITION tfNliDiTOR CB
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ating/Cooling System
residence,including county: ❑ Q 5.Wind Power Device
Adiress(Number deStrefi, O 5 ❑ 0 6.Hydroelectric Power Device
eA"ca 4 it OLO 4 Gts-L li ❑ ❑ .Geothermal Energy Heating/Cooling Device
City,State RP Code County
❑ 4' 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 ❑ 71 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.
Lawailehle-M-all. unties.)
Address(Number and Street)
6-14-18-303-000. 905-007
City,State ZIP Code County
Prim E-mail