Homestead_VensonSDF ID:
Addr¢ss (Numberand Stree[J
rne
Bob Zoss Law OKce. LLC
Company
:,
Evansville. Indiana 47715 (
Emaii
E.
_Rhonda K. Venson
Seller]�NamJej�;jjFppevrsonconve}vncedocument
�LriTT �1( �I�r `Nnr f
Ad.�rgs (Number m d Street)
�n,.ir �a�. .7/li �/%%?0
Ci.y, S:atG and Z/PCod
�. /�
Sello 2- Nome as appmrs on conveyanre docvment
Add�ess (NUmb¢r ond Streer)
liry, StatG and ZIPCOde
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my kno�vledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
j �� v. P�n
Stynamreaf5eller � I Sgnatureo(Seflu
.,� � �... �-�..,.r.� 215� lfi 17
APPLICATION FOR
I � Name as
`�i.ry: S;atG and ZIP Lode
(
Telephon¢Numbu E-mall
TftE S.f1,FS DISCLOSURE FORDI NAY BE USHD TO APPLY FOR CERTAIY DEDUCf10N5 FOk
YES NO
0 ❑ 1. Will this property be the buyer's primary V
residence? Provide complete address of primary
residence, including counTy:
Adlres(Numberand50-ee[)
Ciry, Srute LPCode Caunry
❑ � 2. Does the buyer have a homestead in lndiana to be
vacated for this residence? Ifyes, provide
complete address of residence being vacated,
induding county:
Addras (A'umber and Street)
Ciry, Smfe LPCode Counry
Buyer 2- Name as appmrs om m�vryanre dacument
Addreu (A'um6erand Street)
Ci.y, Sm;G cndZlPCade
OF THOSE THAT APPLY.
APPLY
� � 3. Homestead�
. gy Hearing/Cooling System
❑ ❑✓ S. Wind Power Device
❑ � 6. Hydroelettric Po�ver Device
❑ Q 7. Geothermal Energy Heating/Cooling Device
❑ ❑✓ 8. Is this property a residenrial rental property?
❑ � 9. Would you like to receive taac s[atements for this
property via e-mail? (Provide tontact informatlon
6elow. Please see instructions for more informatlan.
Notavaila6le in al1 counties.)
�/e-/a- -�3�- oao. �3-�a7
otmertonmc[name
P maii
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance crith IC 6-11-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Securiry and Driver's License/Other numbers are not necessary if no Homestead Deduction is
5(gnaNre ofBUyer2/Spouse
Prtnted Legal Name ofBuyer2/Spouse
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LastSd{qiCSa�Buyer2/SpauseDriver's Smte L¢stSDigiCSOfSocialSecunty
License/lD/OfherNum6er Num6er Lirense/(D/Ot6erNum6er
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