HomeMy WebLinkAboutHomestead_Rivera (2)ID:
Rav M. Drulev Attomev No 4759-26
Frcpvrcr oJNe Sala Dlsdomre Form Ttle
naa��:
Ciry, SmtG ondLPCode
_Diane I_ Wilcon forma�v Diane 1 C radlp,y
Seller ] � Nameasappmrton ronveyonttdoaummt
75?0 Old Bmnvillr H
Addrus(NumbnandShtrQ
FvansvillP IN 47715-1790
_ .
Law OKce of Rav M Drulev
E-moil
Shcer Z- Name ns appeors om m�veyvnce tlotument
Add�est(Numberond
and 21PCOde
Under penal[ies o(perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is hve, correct
anA� mple[Q as requ;ed by la,l.�, and is prepare in ccordancz wi[h�IC o•1.1-S.S, "Real Property Sales Disdosure Act".
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Buye� 1- Name vr aypevrs�� �^^�•°^nre
AOOreu (NUmbe�unCSo-atJ
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CENTAI.4 DEDUGTIOYS FOR THIS
Q � 1. Will this property be [he buyer's primary (
residence? Provide complete address of primary
residence, induding county:
AdAresr(NUmber and Sveeq
Fort Branch. IN 47648 Gibson
C1ry.5mte2/PCode [ounry
�[] 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacate¢„
includingcounty: � � r-�
Addrw (Number and Sveet)
Ciry.SmreZ/P[ode
Counry
Signomre o(Seller
ronve�anadocumm[
Addrers (Number ond Strw�)
THAT APPLY.
❑ 3. Homestead
i-4�1.i I 4. Solar Energy Heat' /Cooling System 55 p
� Q 5. Wind Power Device h �
❑ Q 6. Hydroelectric Power Device
�011
❑ ❑d 7. Geo[hermal Energy Heating/Cooling Device
❑ Q 8. Is this property a residential rental property?
❑ Q✓ 9. Would you like to receive tax sta[ements For chis
��property via e-mail? (Provide contacc information
belo see instructlons for more in/armation.
� � ry, Nqta ilable in all counties.)
E mail
Under penal[ies of perjury, 1 hereby certify that [his Sales Disclosure, [o [he 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 Ad". (Note:
Spouse informati Social Secunty}� nd Driver's �ce/nse/Other numbers are no[ necessary if no Homestead Deduc[ion is
being filed.) � ` r ) � � p �
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mted Legal Na�'`o(9vyrr 1 �
lDriver"s Sm[e LattS
License/!D/Other Num6er
Sign Da[t (MN/DD/YYYIj
Number
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7/SpouseDriver"s Stn[e Las[SDigiecaj5ocialSecuriry
Num6er License/!D/OrherNum6er