Loading...
HomeMy WebLinkAboutHomestead_Potts (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ---. Amy Pollard Escrow Officer Preparer of the Sales Disclosure Form Title 7321 Eagle Crest Blvd. Ste.A Foreman Watson Land Title, LLC Address(Number and Street) Company Evansville, IN 47715 E-mail E SELLER(S)%GRANTOR(S) _,.:. ; ._.- - -- -_ ,_... , . - ��C"6•e - -�S me� .. . W`�- --.�u w._ _ Shane Osmer C Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1272 W Chukar Holw I _-19 \AI. C.tnuVc r 14-o1 u) Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 V,1AbSj-c4 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 equired by law,and is prepared in accordance with IC 6-1.1-5.5,' Property Sales Disclosure Act". pafSeller iSigrature of Seller Shane Osmer 07/3_0/2020 ( c- ' r1 -p OS nn ,Pr- 1 3 D )01 Printed Name o Seller Sipn Date MM DD Printed Name o Seller S'' Date(M DDAttlj F.BUYER S ':GRANTEE S APPLICATION.FOR T15116PERTY fIski5t)),tral 0 i ':4 I,DENTIFY ALL ITEMS THAT APPLY_- __ __ __,1 John D Potts T u Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance e 11,' 68 W. 800 S.Apt 8208 Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 AUG 4 2020 City,State,and ZIP Code City,State,and ZIP Code E-mail Telephone Number E-mail _ THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THosallICKINICOUNTY AUDITOR YES NO CONDITION YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 1272 W. Chukar Holw ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State Zl Code County ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 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: below.Please see instructions for more information. Not available in all counties.) Address(Number and Street) City,State ZIP Code County imary property owner contact name E-mail Number License/ID/Other Number