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HomeMy WebLinkAboutHomestead_Hazel INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D PREPARE-1 _ _.. Roman Ricker Attorney Preparer of the Sales Disclosure Form Title 219 N Hart Street Partenheimer,Kinkle&Ricker Address(Number and Street) E-mail E SELLERESVGRAN,TOR(S1._.r_. . . .. Jerri J. Daffron Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 8679 KY 1078 N Address(Number and Street) Address(Number and Street) Henderson, KY 42420 City, 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 complete as req • Ly w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Jerri J. Daffron Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) IT BUYER(S)/GRANT.EEM-APPLICATION__F,ORP-ROPERTYTAXDEDUCTIONS=,IDENTIFYALL;I TA!.:11 :'• Janice J.Hazel Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1120 N Main St. SEP 15 2020 Address(Number Street) Address(Number and Street) , , , rPrinceton, IN 47670 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 THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary z ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: _1120 N Main St. ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County El IZ 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 ❑ ❑ 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) 21-12 -0 - SO'1 0O1 . $ 3 ?- 028 City,State ZIP Code County Primary property owner contact name E-mail ID/Other Number