Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Homestead_Grimes
INDIANA SALES DISCLOSURE FORM SDF ID: Pag 2 P1ZI T''iOR_: . ..T. I Sr v `'_z, C` - g .,��_tZI K. M "S g __: „$,',_nNIZ..Z,,. ,.ka..,i ...EC 3,.... t s "s Britany Bradshaw Agent Preparer of the Sales Disclosure Form Title • 226 W Broadway Broadway Title, Inc Address(Number and Street) Company Princeton, IN 47670 812-386-1687 Britany@Broadway-Title.com City,State,and ZIP Code Telephone Number E-mail EE SELIEt C 1V k P -, { )/.�I�. FOR{s)�._.... .� ��, _ _ .�... .� ._. ' � .'� -, - r ,: .__�'r�r-�4 <.r:;•� ...F`..�_� ��i,L'.�.',��;.r�. .� .�:�c,Y.rt.... �'sr=_..�. . _:�_-:. t. ..3 _-.�.;._.�•t-s.�`'G�sr.,'!� ._�-�:, Addie J Thornley Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 6621 N SR 65 Address(Number and Street) Address(Number and Street) Hazleton,IN 47640 City,State,and ZIP Code City,State,and ZIP Code 3CA — 460 - c is 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 corn ete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Sig re ofSe er Signature of Seller Addle J Thornley J i5. 2�" Printed Name ofSeller Shin ate(MM/OD/YYYY) Printed Name ofSeller Sign Date(MM/DD YYYY) '_ : (.5p AWPPLI,C ,TIOLV .OItPR_OPER'I'1'AEDUCT,1QKS 1DMI. 'AVITEMSiTAMPLSZ y a`, n' Dustin M Grimes • er - ame as appears on conveyance document Buyer 2-Name as appears on conveyance document i/ PIA X R Address(Number and Street ' Address(Number and Street) 54/1 71g7'. l,�t7`g�( City,State,and ZIP Code City,State,and ZIP Code FILED Telephone Number E-mail Telephone Number Jul 17 2020 E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPIjF}/ • YES NO CONDITION NO CONDITION ❑✓ ❑ 1.Will this property be the buyer's primary E ❑ 3.Homestead GIBSON COUNTY AUDITOR CB residence? Provide complete address of primary ❑ ✓ eating/Cooling System residence,including county: 6621 N SR 65 ❑ 0 5.Wind Power Device Address(Number and Street) ❑ E 6.Hydroelectric Power Device Hazleton,IN 47640 Gibson ❑ © 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ 2.Does the buyer have a homestead in Indiana to be ❑ E 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, property via e-mail?(Provide contact information including county: • uctions for more information. Not available in all countie . Address(Number and Street) 26-05-01-400-003. 238-017 City,State ZIP Code County ac n me E-mail J 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".(Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed.) Signature of Buyerl Signature of Buyer2/Spouse Dustin M Grimes 'Q7/(/PC12v Printed Legal Name of Buyer I Sign Date(MM/OD/YYYY) Printed Legal Name of Buyer Buyer 2/Spouse Sign Date(MM/DD/YYYY) Last 5 digits of Buyer 1 Driver's State Last 5 Digits of Social Security Number Last 5 digits of Buyer2/Spouse Driver's State Last 5 Digits ofSocial Security License/ID/Other Number Number License/1D/Other Number