HomeMy WebLinkAboutHomestead_FrederickINDIANA SALESDISCLOSUREFORM SDFID:
Preparer o(Ihe Soles DBdosu�e Form
� N. Hart St. PO Box 13
�ress (Number ond Svee�)
inceton.IN 47670
Lityt Sm[e, and Z/PCode
Se/ler 1- Name as appears m mm�e�•anre documen[
Address (NUrnber and Sveet)
�
TiNe
Hall. Partenheimer & Kinkle
Company
Telephone A'um6er
Seller? - Name os oppears m ronve��ance dacumen�
Address (A'umber and StreetJ
Ciry.Smte. andZlPCode
E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
a mplete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
� �� J -� % /v� - -
Srgnamre o(Seller
- APPLICATION FOR PROPERTY TAX
372 E. 775 N.
Address (Number ond SireetJ
�leton IN 47640
Sm�e. and Z/P lode
57gnamre a(Seller
ALL ITEMS THAT APPLY
Nomeas
Address (A'umber and 5[ree[)
Hazleton IN 47640
�
TNE SALFS DISCLOSURE FOR�N MA1' BE USED TO APPL7' FOR CERTAIY DEUUCf10�5 FOR THIS PROPERTI'. IDEYTIFY ALL OF THOSE THAT APPLY.
�✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of F
residence, including county:
410 lohn Str t
Address (Number and Sneet)
Fort Branch IN 47648 Gibson
cirv. smre zIP code counry.
�✓ � 2. Does the buyer have a homes[ead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
induding county:
372 E. 775 N.
Addrus /Number and Svee[)
Hazleton IN 47640 Gibson
Ci%Smte ZIPCode Caunry'
✓Q ❑ 3. Hom [ead
. Solar Energy Heating/Cooling System
� Q S. Wind Power Device
� Q 6. Hydroelech ic Power Device
❑ ❑✓ 7. Geothermal Energy Heating/Cooling Device
� 0✓ 8. Is this property a residential rental property?
� ❑✓ 9. Would you like to receive tax statemenrs for this
property via e-mail? (Provide rontact in%rmation
6elow. Please see instructiais for more injormation.
Notavailable in all counties.)
�, �-�9��s;3oi��3 vab
Cody and Taylor Frederick �
awner canmct name
E-mail
Under penalties of perjury, 1 hereby cer[ify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.)
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PnnredlegalA'ameo/Buyerl SignDate(MM/DDM'n7
Last 5 digiGS o�Buyer ] Driver'S State Las[ 5 Digifs o(Social Securiry Num6er Last 5 digiGS o(Buyer 1/Spouse Driver's Smte Lost 5 DiglGS ojSocial Secunry
License/ID/OlherNum6er Num6er Lirense/ID/OCherNum6er