HomeMy WebLinkAboutHomestead_Kern (3)t\DU\A SALES DISCLOSURE FOR\f
Form
Ad1rm (Number artd Stra[)
Evansville, IN 47715-
U,n, Smte, nIM ZIPCodt
E.
Stephen G. Burkett
SAel 1- Name as appears m ronveyance documm[
Tri Cirde Lane
Addras (Number and StrertJ
Haubstadt, IN 47639-
Under penaldes of perjury, l hereby certify that this Sales Disdosure, to the bes
anid.yon;ple[e as re��red \(aw, and is prepared in accordance IC 6-11-SI
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,..�.�ynamreoJ5e1ler Signatu�eoJSeller �
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F R(Sl/G � E(S1�-APELICATION:FORPRO?ER7YTAXDEDUCTIO�'S-1DGN
�shua R. Kem f
Buyerl-Namemappm ncomryvnteEoavmmt
Addres' (Num6er and Suee[)
aubstadt. IN 47634
THE SALFS DISCLOSURH iORM MAY BE USED TO APPLY FOR CERTAIY DEDUCTIONS i0R TNIS
�x � 1. 4Nill this property be [he buyer's primary
residence? Provide complete address of primary
residence, including county:
5. TRI CIRCLE LANE
Addres(NUmberandSo-eeeJ
Haubstadt, IN 47639 GIBSON
Gry,S:u¢ZIPCode Gunty
��c] 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:
AEdrea(NUmbvaMSbeetJ
Gry, Smte ZIP [ode Lounry
Bayer7-�Yemrm'
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THOSETHATAPPLY.
�x � 3. Homeste
. nergy Heating/Cooling System
5. WindPo�ver Device
❑ Q 6. Hydroelectrfc Power Device
❑ Q 7. Geothermal Energy Heating/Cooling Device
� Q 8. Is this property a residential rental property?
❑ Q 9. Would you like [o receive tax s[atements for this
property via e-mail? [Provide contoct in%rmation
be(ow. Pleose see instruc�ons(ox more informadon.
Not ovailable in oll counties.)
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Prlmarvwdnertvownermnmanome E-mall
Under penal[ies af perjury, l hereby certi(y tha[ this Sales Disclosure, to [he best of my knowledge and belief, is true, correc[
and complete as required by law, and.is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse interm�n, Social Security and Driver's License/Othe� numbers are not necessary if no Hoinestead Deduction is
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