HomeMy WebLinkAboutHomestead_Payne INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Chris Sullivan Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville,IN 47715 (
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Deborah K.Carroll
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
500 S Cathy Drive 500 S Cathy Drive
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670 Princeton,IN 47670
this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co lete as require bx law, prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller ii__ ` l Signature of Seller
Deborah K.Carroll P 41'6�1 l� r f hr/iq L
Printed Name of Seller Sig Dat (M�,M/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
' wa 1 F NC yY � -T_L a3
,.ERfS '. `NTEEfSl--.gAIIPIICATIONA1t0RPRO?ERTYTAX:DEDUCfTlONS IDENTII?�1lALL I>TE S tiAMI PI K4 F .sue
Robert Payne
�yyex3..Rl ears on conveyance document Buyer 2-Name as appears on conveyance document
329 S 5th Ave,Apt 51 329 S 5th Ave,Apt 51
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670 Princeton,IN 47670
\ Telephone Number E-mail
1..ln0
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDE F THOSE THAT APPLYn,
YES NO CONDITION NO CONDITION lJ�Y r�W�O►
❑ 1.Will this property be the buyer's primary C ❑ 3.H mestea GIBBON COUNTY AUDITOR CB
residence? Provide complete address of primary Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑ El 5.Wind Power Device
310 s(Washington St El 06.Hydroelectric Power Device
Address(Number and Street)
Oakland City,IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,star IPCode County ❑ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 9.Would you like to receive tax statements for this
��"" vacated for this residence? If yes,provide property via e-mail?:(Provide contact information
complete address of residence being vacated, below.Please see instructions for more information.
including county:
Not avai le m aft countte.
Address(Number and Street) Robert Pa a 26-14-18-302-000. 679-007
Number License/ID/Other Number