HomeMy WebLinkAboutHomestead_LiggettINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D.PREPARER � � - - � '
SHERI L GREENE '
Prepa�er o/Ne Sala Diulosvre Fortn Title
1122 E OHIO ST
Addrezs(A'umberand5veet] Compony
PRINCETON IN 47670
Ciry, Smre, andZlP Lode Telephone Num6er E-mai/
E. SELLER S GRANTOR S
AI AN M PIIRCELL .ILILI A PURCELL (�CA JULI A. KIEFFFR)
Sdier ]- Nome as appears an �m+mryance daYumenl 1 Se11erT � Name as appears om m�veyaIn'ce dxumenl
-PQ�B6X'173' l�� �A� c1e��11'i�i L�A11�' .on o.`.`...�^.Trs-v ..., � �� 5vL1.'t'N �2� Q YU.V �Y1�:
Add�ea(A'vmberand5mee[J Address(Numberand5veetJ �
HAIBSTADT IN 47fi39 HALIBCTADT IN 47644
CiN, Sm[e, andZlPCode
E-mail
Under penal[ies of pe_rj 1 hereby certify that [his Sales Disclosure, to the best of my knowledge and belief, is true, correct
and co �as uire y law, and is prepared in accordance wi[h IC 6Q1-S.S, "Real Proper[y Sales Disclosure Act".
/� / �Ae: A �,��s2�.
na[ureof5e(I r aoireof5eller �] /
A1 AN M PI IRf:FI 1 �l ��2017 II II I A PI IRCR L —I� / e� /2011
P' � meo e�� SianDare Ma/DO PnncedNameo Selle� SianDatef�w/DO
. BUYER S GRANTEE - APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
LAURIE A. LIGGETT
8vyerl-Nammso . rom�ryanadarumen[ Buyer2-Nomeasappearsonronveyanttdo[ummt
178 E R 768
Numbermd Suee[J Address (A'umber and Street)
FT BRANCH I 648
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Tefe honeh'um6er E-mail Tde haneNumber E�mail
TNESALFSOISCLOSIIREFORAIMdYBEUSEDTOAPPLYFORCERTdi\DEDUCTI015FORTHIS RTY.IOEKTIFYd IOSETHdTAPPLY.
5'ES NO CONDITION I 1'FS RO C06UIT10\
❑J � 1. 41+i11 this proper[y be the buyer's primary ❑✓ ❑ 3. Homestead
residence? Provide complete address of primary . o ar nergy Hea[ing/Cooling Sys[em
residence, including county:
++uq P SR 168 ❑ ❑✓ 5. Wind Power Device
Address(A'umberondSneeQ ❑ ❑✓ 6. Hydroelectric Power Device
FT BRANCH. IN 47648 GIBSON � � 7. �eothermal Energy Heating/Cooling Device
Ciry, Smre 21PCode Lounry
� �✓ 2. Does the buyer have a homestead in Indiana to be � �$� �s [his proper[y a residen[ial rental property?
vacated for [his residence? If yes, provide ❑ ❑✓ 9• �Nould you like ro receive taK s[atements for this
complete address of residence being vacated, property via e-mail? (Provide contact informotion
including county: below. Please see instructions for more in%rmation.
Not available in all counties.)
Addrecs(A'umberand5veet) n / � �� /� �� ' oQ� 9� �a
L a
Ciry, Smre Z!P Code Counry
Rimarypmperryownerronmr[name E�mail
Under penal[ies of perjury, 1 hereby cer[ify [hat [his Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance wi[h IC 64.1-5.5, "Real Proper[y Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduttion is
being filed.) -
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Signamrro(Bvyerl � SignamreofBUyer2/Spouse
PnnredLegalNameofBUyerl SignDarepfH/DD/YYYY) Pnn[edLegalh'ameo/Buye�2/Spouse SignDa¢(MH/OD/YYI'YJ
umber LastSdigi[safBuyer2/SpouseDriver's Smte LastSDigi[saf5otia15ecurity
License/10/OtherNum6er Number License/lD/OtherNumber