HomeMy WebLinkAboutHomestead_Madison INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Patti Kolb Closing Manager
Preparer of the Sales Disclosure Form Title
226 W Broadway St Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670
E-mail
E.SELLER(S)/GRANTOR(S).
.
Melinda Bradshaw Preusz
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
505 N Main St
Address(Number and Street) Address(Number and Street)
Patoka. IN 47666
City,State,and ZIP Code City,State,and ZIP Code
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".
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Sign tore of Seller Signature of Seller
Melinda Bradshaw Preusz k-162-40a0
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F.B ' s. TEES APPLICATION FOR PROPERTY TAX_DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY. _ - j
Kane Madison .
--- . •• appears on conveyance document Buyer 2-Name as appears an convey1 _lli,
403 W Arkansas St.
Address(Number and Street) Address(Number and Street)
Hazleton, IN 47640
E-mail Teppbene Nwnh E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO' ''1S PROPERTY. IDENTIFY ALL OSE T
YES NO CONDITION YES NO CONDITION GIB COUNTY AUpI�O�
Z ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of prim• • FA '. o'a net gy acing/Cooling System
residence,including county:
403 W Arkansas St. El ❑✓ 5.Wind Power Device
Address(Number and Street) ❑ IZI 6.Hydroelectric Power Device
Hazleton, IN 47640 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 ❑ 0 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: se ow. ' ease •• " - " 'ens or more information.
Not available in all counties.)
Address(Number and Street)
4
• moo. a5CIo ► •
City,State ZIP Code County �'�+
Primary property owner contact name E-mail
Number License/ID/Other Number