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' 4703 THEATER DRIVE REGIONAL LAND TRLE
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EVANSVILLE IN 47715
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Under penalties of perjury, e
and t ple[e as re uired 6 la
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.SUY£R(S)jGRANTEE(S �APPI
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certify [ha[ [his Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
�1 is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Ac[".
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THE SALFS DISCLOSURE FORM MAY BE USm TO APPLV
FOR 77�5
YES 40 [OM1Df1704
� 1. Will this property be [he buyer's primary
residence? Provide complete address o n ary
�Isidence,ccludingcounty:
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�� 2. Does [he buyer have a homestead in Indiana to be
vaca[ed for this residence? Ifyes, provide
comple[e address of residence being vaca[ed,
including county:
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❑ 3. Homestead
n 4. Solar EnerE
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THATAPPLY.
S'P�ind Power Device
6. Hydroelec[ric Power Device
Sys[em
7. Geothermal Energy Heating/Cooling Device
B. Is [his property a residen[ial renfal property?
9. Would you like to receive tax statemenCS for this
property via e-mail? (Provide ronmct information
below. Please see instrvctions for more informadon.
No[ available in all countles.J
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Under penaldes of perjury, I hereby cer[ify [hat this Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6•11-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse informatlon, Social Security and Driver's License/Other numbers are not necessary if no Homestead Dedu�don is
being filed.) . • „ �
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