HomeMy WebLinkAboutHomestead_Besing INDIANA SALES DISCLOSURE FORM SDF ID: 2020 • Page 2
D. PREPARER
Abbigail Moers b5£4 5X) 4CATk
Preparer of the Sales Disclosure Form Title Od
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (
mail
E. SELLER(S)/GRANTOR(S)
Chrysanne Rogers
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
106 N. Hull St.
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
City,State,and ZIP Code City,State,and ZIP Code
(
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 IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signatur Sign
ature'" /LT nature of Seller
Chrysanne Rogers 11/30/2020 11/30/2020
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller JI Igi):1,,a,MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL I T"A ?
3�rookng� . Lance Allen Cr
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on convej W G dficumaZ U
203 W. Maple St. 12574 S. Owensville Rd.
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639 GIBSON CDtiN I Y AUDITOR
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.
YIE0S7 NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyer's primary ❑ 3. Homestea
residence? Provide complete address of primary ' ❑ 0 4. Solar Energy Heating/Cooling System
residence, including county:
0 0 5. Wind Power Device
106 N Hull St. 0 0 6. Hydroelectric Power Device
Address(Number and Street)
.Haubstadt, IN 47639 Gibson; ❑ El 7. Geothermal Energy Heating/Cooling Device
City,State Code County 0 El 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be 0 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete • property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
Of y/8 -34 - yO.1 - 000 . L3S-00Y
City,State ZIP Code County Primary property owner contact name E-mail