HomeMy WebLinkAboutHomestead_Englehardt�
Rav M. Drutev Attornev No. 4759-26
Preparer ofNe Sala Disdosure Form Ttle
Addres (Numberand So-eetJ
Law Office of Rav Druley '
lompany
Fort Branch IN 47648
E-mail
Jamie L En9tehardt
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Sel(er 2- Name as oppevrs on conve}anre dacummt
Addrets (Number and StreetJ
Ciry, SmtG and LPCade
of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correct
�r�quiqe2,b,yla�fv. and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Ad".
B�yer 1- Name us aypevrs on
309 E. Sindair
Addrn's (h'umberand Stree[f
Fort Branch IN 47648
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THE SALFS OISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIO\S FOR
�✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of F
residence, including county:
Addras (Number and Sbee[)
Fort Branch. IN 47648 Gibson
Ciry, Smte LPCOde County
� �✓ 2. Does the buyer have a homes[ead in Indiana Co be
vacated for this residence? If yes, provide
comple[e address of residence being vaca[ed,
including county:
Addras (Number and Stree[)
Ciry, Smte ZIP lode
SgnaareoJShcer
Buyer 2- Name us aypairs on ronveyanre dacvmmt
Addras(NUmberandSVeet)
[lry, Sm[e, ond vPCOde
OF THOSE THAT APPLY.
Q✓ � 3. Homes[ead
0 0
� �
� ❑�
❑ ❑�
System
S. Wind Power Device
6. Hydroelectric Power Device
7. Geo[hermal Energy Heating/Cooling Device
8. Is this proper[y a residen[ial renUl property?
9. Would you like Co receive tax statements for this
property via e-mail? (Provide contact informadon
below. Please see instructions far more informadon.
Not availo6le in all [ounties.)
lovnry
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Vnmarvomormewnerronmr[nome E-mail
Under penalties of perjury, l hereby certify [ha[ this Sales Disdosure, to the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance with IC 641-S.S, "Real Property Sales Disclosure Act". (No[e:
Spo�se informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
� filed.
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� IIONf¢O B � / I1 ^ Signamreo(Buyer2/Spouse
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Pn'nted Legal Name o(Buyer 2/Spouse
S�qn Daf¢ (MH/OD/YYYI'f
LastSdigi6ofBuyer7Driver's Sttite LastSDigiGSOfSocial5ecurityNumber I Las[SdigitrofBuyer2/SpouseDnver's Sra[e LastSDigiGro�SocialSecunty
Lireue/lD/O[herNumber Num6e� License//D/OrherNum6er