HomeMy WebLinkAboutHomestead_PowellI \ Nh^SM.ES DISCLOSURE I
PREPARERi•.`,--.z...�.�, -':
<elli Kelloag
Repartr of the Sales Disdomre Form
Recordina Manager -
Title
Richmond Tiile Services LP
Company -
Plano.Texas 75093
um6er E.
mail
E. SECf:ER S GRANTOR S ` ` � ' " ' ' - _ .
C� L P�well HeathPr L Barkrr
Se0er7-Nameasappearsonronveyuncedocvment Se/Ier2�Nameasa earsomm�v
vv eyanredxumen[
7763 South Andr an 7763 South Andr. ane
Address (A'um6er and SPee[) Addres (NUmber and Stree[J
Fort Branch IN 4784A Fort Branch IN 4764A
Ciry, Smte. and ZIPCode Ciry, Sruu, ond ZIP CoCe
_
Under penal[ies of perjury, I hereby certify that this Sales Disclosure, to the bes[ 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 Ac[".
s��am�eo�sene.
Brrjer I- Nome as aypmrs on canveyonre documenl
7763 Soulh Andree lane
Addre.ct (Num6er andSvreo)
QqnaNre o�5eflet
�."- I" :..1." 1 1
Heather L Powell
Buyer2 � Nome as appmn on mmeyanre dacummt
7763 South Andree Lane
Address (Num6er and Strre[J
Fort Branch IN 47648
THE SALFS DISCIASURE FORM MAY BE USEO TO APPLY FOR CERTAI,Y DEDUCf10N5 FOR THIS PROPERTY. IDE.YTIFY ALL OF THOSE THAT APPLY.
Q✓ � 1. Wil1 this property be [he buyer's primary
residence? Provide complete address of primary
residence, including county:
7763 South Andree L anr
Addre.ss (Num6er and Sveet)
Fort Branch. IN 47648 Gibson
Ciry, Smre ZIP lode Counry
❑ �✓ 2. Does [he buyer have a homestead in Indiana to be
vaca[ed for this residence? If yes, provide
comple[e address of residence being vacated,
including county:
and5vee[)
Ciry, Smu ZIPCode Counry
Q✓ ❑ 3. Homestead
� Q 4. Solar Energy Heating/Cooling System
� �✓ S. Wind Power Device
❑ Q 6. Hydroelectric Power Device
❑ Q 7. Geo[hermal Energy Heating/Cooling Device
❑ �✓ 8. Is this property a residential rencal property?
❑ ❑✓ 9. Would you like to receive tax sia[ements for this
property via e-mail? (Provide contoct information
6elow. Please see instructions for more information.
Not available in all counpes.)
a �-Ig-l�- �a3- «>, .2 � 3 -oab
Cory L. 8 Heather L. Powell
Pnmarypro0ert3'ownerronmctname E-mai/
Under penalties of perjury, 1 hereby certlfy tha[ this Sales Disdosure, to [he best of my knowledge and belief, is true, correc[
and complete as y and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (No[e:
Sp� ormatlon, Social Se rity and Driver's License/Other numbers are�ot necessary if no Homes[ead Deduction is
IN
Las[Sdigiao(Buyer] Driver't Smie
License/ID/Other Num6er
3/27/2010 Heaiher L Pnwell 4� 1 010
SignDau(Niu/DD/YVYh PnnredLegolNOmeo/Buyer2/Spouse SignDate(ax/ou/Yrvh
IN
Las[SDigiaof5ocia15ecuntyNumber Las[SdigiaofBuyer2/SpouseDriver"s Smte LastSDigirsofSocial5ecuriry
Num6er License/ID/OtherNumber