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HomeMy WebLinkAboutHomestead_MejiaINDIANA SALES DISCLOSURE FORM SDF ID: Kyle R. Walton Pre parer of the Sales Disclosure Form 5720 S. Eastern School Rd. Address (Number and Street) Pekin Indiana 47165-8017 City, State, and 7.1PCode Title Company 812.620.6651 Telephone Number F.-mail r Sabre Invectmentc I I [` Seller 1 - Name as appears, on conveyance document Seller 2 - P.O Box �074 Name as appears an conveyance document _ Address (Number and Street) Address (Number and Street) Carbondale ILI INOIS 6 QO city, State, and ZIP Code City, State, and ZIP Code 618.457.4334 Tele hone Number F-moil Telephone Number ail Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete as r red by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". .Signature nfSeller Signature ofSeller Kenny Rochman PreG �r Printed Name o%Seller _ ..__ __Jose Meiia Buyer 1 Name as appears an conveyance document 819 W. Russell St. Address (Number and Street) Peoria ILLINOIS 61606 City, Stote, and ZIP Code TnlanFnno hr -h— Carolina Meiia Bayer 2 - Name as appears on conveyance. document 819 W. Russell St Address (Number and Street) Peoria ILLINOIS 61606 City, State, and ZIP (-.o(te THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CoNntTIM i © ❑ 1. Will this property be the buyer's primary residence? Provide complete address of primary residence, including county: 408 5 CibGnn ST Address (Number and Street) Princeton Indiana 47670 GIBSON City, State ZIP Code County ❑ Z 2. Does the buyer have a homestead in Indiana to be vacated for this residence? If yes, provide complete address of residence being vacated, including county: nuaress ummoerana street) YES 0 ❑ 3. Homestead r cm El [Z4. Solar Energy Heating/Coo)stem � ❑ ❑✓ S. Wind Power Device r�I ❑ Z 6. Hydroelectric Power Devi 'e LU ❑ 7. Geothermal Energy Heatin %poling DK1ce ❑ 8. Is this property a residentif' at property? ❑ Z 9. Would you like to receive tax statements for this property via e-mail? (Provide contact information below. Please see instructions for more information. Not available in all counties.) City, St ateZIPCode County z — 67— 43 — ca _ `ter-) Primaryproperty owner contact name G-moil Under penalties of 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". (Note: Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead. Deduction is being filed.) .,,grdlurl of a' 6M _ ' •�'v K Signature of BuyerZ/Spouse Jose Meiia Printed legal Name of Buyer! Carolina MPiia Sign Uate (MMIDDlyYM Printed Legal Name of Buyer 21Spnuse .Sign Date (MM1uD/Yvv� .Lost5 digits of Buyer 1 Driver's State Last 5 Digits of Social Security Number Last 5 digits ofBuyer2/Spouse Driver's State Last 5 Digits of Social Security License/ID/Other Number Number License/ID/Other Number