State Form 46021 - Sales Disclosure Form - Indiana
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SALES DISCLOSURE FORM
State Form 46021 (R7/6-08)
SDF ID
County
Year
Unique ID
Prescribed by Department of Local Government Finance
Pursuant to IC 6-1.1-5.5
__________________________
SDF Date:
PRIVACY NOTICE: The telephone numbers of the parties on this form are confidential according to IC 6-1.1-5.5-3(d).
PART 1 – To be completed by BUYER/GRANTEE and SELLER/GRANTOR
A. PROPERTY TRANSFERRED – MUST BE CONVEYED ON A SINGLE CONVEYANCE DOCUMENT
1. Parcel Number
Check box if applicable to
5. Complete Address of Property
6. Complete Tax Billing Address (if different from
parcel
property address)
A.)
2. Split
3. Land
4. Improvement
7. Legal Description of Parcel A:
B.)
2. Split
3. Land
4. Improvement
7. Legal Description of Parcel B:
B. CONDITIONS – IDENTIFY ALL THAT APPLY
C. SALES DATA – DISCLOSE VALUE OF ITEMS LISTED IN TABLE B,
ITEMS 1-14
If conditions 1-10 apply, filers are subject to disclosure and a disclosure filing fee.
1. Conveyance date
:
_________________________________________________
(MM/DD/YYYY)
YES
NO
CONDITION
2. Total number of parcels:
_______________________________________________________
1. Buyer is an adjacent property owner.
2. Vacant land.
3. Describe any unusual or special circumstances related to this
sale, including the specification of any less-than-complete
3. Exchange for other real property ("Trade").
ownership interest and terms of seller financing.
4. Seller paid points.
(Provide the value Table C Item 12.)
______________________________________________________________________________________________
5. Change planned in the primary use of the
property?
______________________________________________________________________________________________
(Describe in special circumstances in Table C Item 3.)
6. Existence of family or business relationship
______________________________________________________________________________________________
between buyer and seller.
(Complete Table C Item 4.)
______________________________________________________________________________________________
7. Land contract. Contract term
:
________________________
(YY)
______________________________________________________________________________________________
and contract date
:
______________________________
(MM/DD/YYYY)
______________________________________________________________________________________________
8. Personal property included in transfer.
(Provide the value
______________________________________________________________________________________________
Table C Item 5.)
9. Physical changes to property between March 1 and
______________________________________________________________________________________________
date of sale.
YES
NO
CONDITION
10. Partial interest.
(Describe in special circumstances in Table C Item 3.)
4. Family or business relationship existing between
If conditions 11-14 apply, filers are subject to disclosure, but no disclosure filing fee.
buyer and seller?
YES
NO
CONDITION
Amount of discount: $
________________________________________
11. Document for compulsory transactions as a
Disclose actual value in money, property, a service, an agreement, or other consideration.
result of foreclosure or express threat of
$
5. Estimated value of personal property:
foreclosure, divorce, court order, judgment,
condemnation, or probate.
6. Sales price:
$
12. Documents involving the partition of land
YES
NO
CONDITION
between tenants in common, joint tenants, or
7. Is the seller financing sale? If yes, answer
tenants by the entirety.
questions (8-13)
13. Transfer to a charity, not-for-profit organization,
8. Is buyer/borrower personally liable for loan?
or government.
9. Is this a mortgage loan?
14. Easements or right-of-way grants.
$
10. Amount of loan:
%
11. Interest rate:
12. Amount in points:
$
13. Amortization period:
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