HomeMy WebLinkAboutHomestead_Johnson (16) iNDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Darlene Prather Escrow Officer
Preparer of the Sales Disclosure Form Title
5231 Oak Grove Road,Suite A Total Title Services,LLC
Address(Number and Street) Company
Evansville,IN 47715
E.SELLER(S)/GRANTOR(S)
Kevin M.Shultz
Sellerl-Name as appears on conveyance document Seller2-Name as appears on conveyance document
112 Flint Circle
Address(Number and Street) Address(Number and Street)
Boonville,IN 47601
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
c m as requir d aw," is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
/'Signature of Seller Signature of Seller
Kevin M.Shultz 08/31/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Hunter C.Johnson
Buyer -Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
401 N Hull St
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648
City,
E-mail Telephone Number .Se.p 02 2020 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFYALL OF THOSE THAT APPLY.
YES I NO CONDITION YESI NO CONDITION
F.
❑ 1.Will this property be the buyer's primary El 3.Homestead GIBBON COUNTY AUDITOR CB
residence? Provide complete address of primary '
residence,including county: ❑ 0 4.Solar Energy Heating/Cooling System
! �// El El 5.Wind Power Device
eta
`°( / - j' El t 6.Hydroelectric Power Device
Address(Number and Street)
1( �� /� ` /�(J ❑ El 7.Geothermal Energy Heating/Cooling Device
` 6� r .F / u `17& 18 ❑ 0 8.Is this property a residential rental property?
City,State,and ZIP Cod County
❑ ❑X 9.Would you like to receive tax statements for this
❑ 2.Does the buyer have a homestead in Indiana to be property via e-mail? (Provide contact information
vacated for this residence? If yes,provide below.Please see instructions for more information.
complete address of residence being vacated, Not available in all counties.)
including county
Address(Number and Street)
26-19-18-302-000. 851-026
City,State,and ZIP Code County Primary property owner contact name E-mail
Other Number