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HomeMy WebLinkAboutHomestead_McClain (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 . PREPARER W - ' ..riV Y ...... ...i . :.... . _., v r# - - Pah 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 '. s i `��3�as°F•r ti� ...; ,1- _ � iL r�,,a.,-.s.� "°z r. � x�*;,. � r .y `"v �u.�s s �`r � x -��'s-,�:. .,,r- E:SEE (S)/.GRANTOR(S)h. _,._ F. :rev.�. a W �1 - CCti_eril.z�•_ 3 s k ..-__._... __ _. x_.,._ ..�_...._.-.ram .�_ .. _��...�� ....�.�_ _,__._. ,_ Kelly P Haley I on A Haley Seller 1-Name as appears on conveyance documentDep, Seller2-Name as appears on conveyance document ��g-I - 1c- 5 h - Log VrAc=' 645 W SR 68 Address(Number and Street) ' Address(Number and Street) Haubstadt,IN 47639 Haubstadt, IN 47639 City, 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 I 6-1.1- . " Property Sales Disclosure Act". ,4f .C/ Signature ofSel ignatureofSe er , Kelly P.Haley -7 3v dvk) Lori A Haley 7-3 c2 6 Printed Name ofSeller Sign Date(MM/D CYYYY) Printed Name 1:Seller Sign Date(MM/DD/YYYY) ;F ' , S G'°+_.,, EE 440004TIQN FQRiPRQMRTY UD)sDL CTIONMDENTI.FX ALLtiITE.MS-TI ATAPPI.X;a aagg.. ..:.$- 011 . r>A•: a� as appears on conveyance document Buyer 2-Name as appears on conveyance document 301 S Fifth Ave Address(Number and Street) Address(Number and Street) Haubstadt. IN 47639 ES NO CONDITION gi ❑ 1.Will this property be the buyer's primary 0 • 3.Homestead =IBSON COUNTY AUDITOR CB residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 545 W SR 68 ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt. IN 47639 Gibson ❑ ❑ 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 ❑ 21 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: bel eeese see-ins ctions for more information. Not available in all counties Address(Number and Street) 26— —36-403-000. 154-009 City,State ZIP Code County Primary property owner contact name E-mail Number License/1D/Other Number