HomeMy WebLinkAboutHomestead_Keil (5)I\DIANA SAI.F.S DISCLOSURE FORN SDF ID SDO ID 476760 �ge 2 ,
D.PREPARLR
�Samaniha Cutsinger
Aeyare�oJNr Sales OurMSVre Form Title
226 W. Broadway Broatlway Title, Inc.
Address(NumlurorMSVenJ
Ory, 5[ace, ond ZIP Ca1e Teltpho�m.Yember E-mail
E. SELLER S /GRANTOR S
Kevin C Schrttitt Elaine M Schmitt
Srfler ]- Rameas oppeers an mme�vme Jurumrn� Stllrr2 - Name � aFyrvrs on mmerynn�e dorumen:
1a15E950S 1415E950S
Address (NvmMr ond 5[reeQ ACdrtss (NUmber md Sve<a)
Haubstatlt, IN 47639- Haubstadt, IN 47639-
Under penalties of perjury, 1 hereby cer[ify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
an lete as re� ired la �, and is repared in accordance wit IC 6-11-5.5, "� rope � les Dj� ure Act".
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S natu�eo/Seller O Ignatureof5eller ���� �
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. BUYER-S �GRANTEE S- APPLICATION FOR PROPER A7( DEDUCTIONS-IDENTIFY ALL ITEMS THATAPPLY
Mtliany J Keil Lori Keil
Buyrr i� Name na app.nrs om m�vewnce dorument Bvyer 2� Name as nppevrs on ronvrynnre da'ument
3846 E 950 5
Address (Number andStrzet) ree.� �NUmber andSveeQ
Haubstadt. IN 47639- Haubstatlt, IN 47639-
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THE SALES DISCLOSURE FOR?f MAY BE I1SED TO APPLY FOR CERTAI.Y DEDURIONS i0R THIS PPOPERI'Y. IDENfIFY ALL Oi TNOSE THAT
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YES NO CONDITION NO CON�ITION
x❑ ❑ 1. Will this property be the buyer's priman• � ❑x ❑ 3. Homestead
residence? Provide complete address o(p imary � � 4. Solar Energy Heating/Coolin �stem
residence, including munty:
7475 E. 950 S. —�-5.-6VInd-POwer Device -
AAdress(NumberandStrerQ ❑ Q 6. Hydroelectric Power Device
Haubsiatlt. IN 47639 NOT APPLICABLE � � 7. Geothermal F.nergy HeaCing/Cooling Device
Ciry, Sm:e ZlPCode Counry
� � 2. Does the buyer have a homestead in Indiana m be � � 8. Is this properry a residential rental proper[y?
vacated for this residence? If yes, provide ❑ 0 9� �4'ould you like to receive tax swtemen[s for this
complete address of residence being vacated, property via e-mail? (Provide conmct in%rmation
including rounty: below. Pleose see instructions�or more in(ormation.
Mot available in afl counties.J
ne � s n��m � o��ve� �r ��
Ciry.SmteZlpCode Counry
Prlmarypmperryownerronmanamr E-mail
Under penal[ies of perjury, I hereby certify that this Sales Disdosure, to the bes[ ofmy knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[". (Note:
Spouse informa[ion, Social Security and Driver's License/O[her numbers are no[ necessary if no Homes[ead Deduc[ion is
being filed.) r� /1�. , /-��(J�
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Signamre yerl naureo/BVyeil/Spouse
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