HomeMy WebLinkAboutHomestead_BrasherINDIANA SALES DISCLOSURE FORM SDF ID: Pag�
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Kim f2acev
Preparer o/NeSafes Dbdosure Form
Addras (NUmber md Svee[J
Title
Dubois CounN Title Co.. Inc.
Company
Jasoer IN 47546
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Brian Ozley & CtrphaniP OxlPy
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Selfer2 - Name as appeors on tonveyance document
Addras (Nvmber and5tree[)
Ciry, Sm[g ondZlPCode
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E-mail
Under penalUes of perjury, t hereby certify that this Sales Disclosure, to tl�e best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Pro rty Sales Disclosure Act".
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TNE SALPS DISdONRE FORM MAY BE USED TO MPLY FOR ff:RTA1N DmUCfIONS FOR THIS PROPEATY. IDENTIiY ALL OF THOSE TNAT APPLY.
YES NO COYDRION
� 1. Will this property be the buyer's primary �
residence? Provide comple[e address of primary
` f1 '^ , ^ �Seside_ pce, including county:
d�,(.9 V �L �{��l/�i
Addr¢s(Num6erandStreMJ
GI {�50%1
Ciry,SmteZIP de Covnry
� �2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Nvmber and Stree[)
Ciry, Smm
Counry
� 3. Homestead
Y.'.. -..,.�� �, _..
Heating/Cooling Sys[em
U �!' S. Wind Power Device
� � 6. Nydroetectric Power Device
❑ �7. Geo[hermal Energy Heating/Cooling Device
� � Is [his property a residential renWl property?
� �. Would you like to receive tax statements for [his
property via e-mail? (Provide conta[t injormation
below. Please see instrucdons for more in%rmatlon.
Not avai/a61e in all counties.)
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ownercmtaa[name
c�oo� ��/-oa6
E-mail
Under penalUes of perjury, I hereby certify that this Sales Disdosure, to the best of my Imowledge and belief, is We, corred
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". [Note:
Spouse information, Social Security and Drivers Liceuse/Other numbers are not necessary if no H mestead Deducdon is
beingfil d.)n � - .
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SignaWreoj yerl Si na �reo( vyer7 pouse
Pnn LNJOINamt erl SjgnDate(HH/00/YYYYJ R'
Las[Sdigiuo Buyer7Oriver's Smte LostSDigiuo(Sacial5ecuriryNumber LastSd(qitso%Buyerl/SpauseDriver's Smte Las[SDigi[so�5ocialSecuriry
License/!D/OfherNumber Number Lirense/!D/OtherNumber