HomeMy WebLinkAboutHomestead_Sweeney (3)CHRISTOPHER E. CARL SETTLEMENT AGENT �
P, epa�er a(Ne Sala Disdosure Form Title ��
(NumberandSVeet)
EXPERT TITLE SERVICES
lompany
�EVANSVILLE. INDIANA 47708
E-mail
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SFLENAS.CLARK
Sellu]-Nameasappears nconveyan[edxumen[
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Seller 2- Name as appears on ronveyance dacument
(A'umber and Stree[)
Ciry,Smle, andZlPCode
Under penalties of perjury, 1 hereby certify that [his Sales Disclosure, [o [he best of my knowledge and belief, is true, correc[
and co lete as required by I , and ' p epared in accordance wi[h IC 64.1-5.5, "Real Property Sales Disdosure Ac[".
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SigoaNre�eller � Signamreo(Selfer
T.4X
Buyv 1- Nume as appmrs an
THH S1LFS UISCLOSURE FORJI MAY BE USED TO APPLY FOR CERTAIY
Q � 1. Will this property be [he buyer's prirnary
residence? Provide complete address of pri
r' en e,'ncl i gcounty:
/� �S. -a�_ ,
�� Numberand5tree[) � .�
Ciry,5mte7JPCade ) Counry
� � 2. Does the buyer have a homestead in Indiana to be
vacated for [his residence? If yes, provide
complete address of residence being vacated,
induding county:
Addrn's (NUmber and Stree[)
Ciry, SmreTlPCode
CounN
Date
Buyer 2� Name as appears on ronveyante domment
Address (Num6er and Street)
CiN SmrG andZlPCode
PROPERTY. IDE.4TIFY ALL 0}iHQSE THAT APPLY.
0✓ � 3. Homes[ead
4. Solar Energy�J.edUng/Cooling System
U . m Power Device
❑ Q 6. Hydroelectric Power Device
❑ Q 7. Geo[hermal Energy Heating/Cooling Device
� Q 8. Is this property a residential rental property?
❑ � 9. Would you like [o receive tax sta[ements for this
property via e-mail? (Provtde contoc[ informotion
below. Please see instructions far more information.
Not availa6le in a(l counties.)
�?�-/a ��,/o/-003. 5<-a�, 0�� I1
JERAD M. SWEENEY � /ry
PrimarvwonertYOwaerronmc[name E-moil
Under penal[ies of perjury, I hereby certify that this Sales Disclosure, to the bes[ of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance with IC 6-11-S.S, "Real Proper[y Sales Disclosure Act". (Note:
Spouse inform�ion, S�ial Security and Driver's License/Other numbers are no[ necessary if no Homes[ead Deduction is
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Sacial5ecunryNumber
License/ID/Orher Num6er
SignaNre a/Buyer2/Spouse
Pnn[edLegolNameafBUyer2/Spouse S(qnDa:e(Mll/DD/YI'Yp
LastSdigiGSOfBUyer2/SpouseDriver's Smte LastSDigiGSOfSacial5ecuriry
Num6er Lireue/!D/OtherNum6er