HomeMy WebLinkAboutHomestead_WardINDIANA SALES DISCLOSURE FORM SDF ID:
Page 2
P PARER
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Prepar" of the Sala Disclosure Form Tide
Addrar(NumberandS.ItjTAL TITLE SERVICES. LLC Company
ti 1Al CrH Iort s
ST E-mail
Gry,Smtq and ZIP Code EVANSVILLE. IN STE 500
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-E. SELLER 5 GRANTORS ... _ -
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fell" 1- Name as appears on convefunce document
Seller 2 - Name as appears on conveyance document
111(.6 E r% I- ,�dsP fs f
Address (Number and Strew)
Address (Numb" and Sweet)
11_.,.�S-1%Jf, �)y X7639
E -mail
Tele hone Number E -ma11
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and core sire by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Ad ".
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Prin meo Sell" Sign Dow [JKMDhTM Printed Name o Seller Sion NW (KMIDDIYYM
R ER [S GRANTEE (S) -APPLI T]ON FOR PROPERTY. T IONS- IDENTI THAT APPLY
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Bayer 1- Name as appears on conveyance ..men[
Buyer 2 - Hanie as appears on conveyance docu n[
Address(N'umb"and Strew)
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Ad rea um "and Street)
W r&e ao Sx/ u1599
try vu; and ZIPCode
£ -mail
SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS RAT APPLY.
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NO COSDrrION YES NO CONDTON
� ❑ 1. Will this property be the buyer's prim
❑ 3. Homestead
residence? Provide complete address of primary
❑ � 4. Solar Energy Heating/ ,ling System
esidence, including county:
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❑ L29, 6. Hydroelectric Power Device
dress pvumb"a.gso-eet) /'7
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wnn "T /
❑ [5� 7. Geothermal Energy Heating /Cooling Device
Ci ww7JPCode County
[J $• Is this property a residential rental property?
[ ❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ [ 9• Would you like to receive tax statements for this
complete address of residence being vacated,
property via e-mail? (Provide contact information
i clud�i.n(� county:
below. Please see instructionsfor more information.
408 A / / / f LL sr
Not available in all counties.)
,07A,rg7o1 f`l/v �1759? PIKI-
City, Smte ZIPCode Caunry
P-:map•prop":vo:r..er corm; .;amz .. -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 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
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