HomeMy WebLinkAboutHomestead_Block Jr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D PR_EPARER
Steven L.Whitehead Attorney
Preparer of the Sales Disclosure Form Title
Ill N. Hart Street
Address(Number and Street)
E-mail
SELLER[$)%GRANTOR(S)' .,. .. . . i,. -.
Lisa B Block
con.../-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
103 W. Boone Street
Address(Number and Street) Address(Number and Street)
City,State,and ZIP Code City,State,and ZIP Code
Gentryville, IN 47537
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
c plete as re uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Si ure of Seller / / Signature of Seller
1 isa 13 Block 6 l� �(�Q�
Printed Name of Seller Si, Date( M/DD/YYYY) Printed Name of Seller
Q Sign Date(MM/DD/YYYS)
F BUYER(S)/GRANTEE(S1 ,APPLICATION•:FOR PROPERTY TAXDEDUCTIONS .tDENTIEY ALL ITE S:_- _ Y j _.1
John H. Block.Jr. , 1' 1
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears o f cony ., ,,,,,
312 Ivy Lane .
Address(Number and Street) Address(Number and Street) J U L 2 4 MO
Owensville, IN 47665
E-mail Telephone Number {{'' RRSON COUNTY AUD11OR E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ACLIOF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑✓ ❑ 1.Will this property be the buyer's primary ❑✓ ❑ 3.Homestead
residence? Provide complete address of primary ❑ ❑✓ 4.Solar Energy Heating/Cooling System
• residence,including county:
❑ ❑✓ 5.Wind Power Device
Address(Number and Street) ❑ ❑✓ 6.Hydroelectric Power Device
Gibson ❑ ❑✓ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑✓ 2.Does the buyer have a homestead in Indiana to be ❑ 2 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: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
Number License/ID/Other Number
•