Homestead_Williams (20)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
DFPREPARER � ni} ..i. :. . �.�. �-r�: a i,';; s z1: ss. .�.'
Donna Lpnqabauoh
PreparerofNeSaletDislasureFarm Title
� 4Q9 Main SL TOTAL TITLE SERVICES LLC
Addres(NUmberandSVeet) Company
Yncennes IN 47591
E-mail
E. SELLER S GRANTOR S ''- - - - " - ' " ` '
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Lisa L Williams
Seller 1- Name as oppevrs on ronveyvnce daavmmt Seller 2� Name as appmrs an ronv¢ynncedorument
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dres(h'umberand5veet ,/ Address(Num6erand5vret)
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Under penalties of perjury, 1 hereby cer[ify that [his Sales Disclosure, to [he bes[ of my knowledge and belief, is [rue, correc[
and o le[e as yu�ed by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act".
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Lisa L Williams �� 9� �%'
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F.BUYERS GRANTEES -APPLICATIONFORFROPERTY-TAXDEDUETIONS-.IDENTIFYALL-ITEMS;THATAPPLX ._.=,`; •:�
Joseoh M. Williams Jana E. Williams
Buyer I- Name as appeurs m mnveyance dx men[ /J I Buyer 2-,Yame as oppears on mmeyanre darvment
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.9ddress(Num6erand5vrel) I ��/ / Address(Numbe�ond5tree[)
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E-mail Tele honeNumber E-mail
TNE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEUUCI'IONS FOR THIS PROPERTY. IDENTIFY ALL OF TNOSE TNAT APPLY.
YFS NO COFDITION YFS NO COKUITIOA
� 1. Will this property be [he buyer's primary �� 3. Homes[ead
residence? Provide comple[e address of primary � � 4, Solar Energy Heabng/Cooling System
residence, including county: � �' S. Wind Po�ver Device
.r % o t{ � . T,�a ,�t �f
Adt4rs(Numberand5veetJ ❑ � 6. Hydroelectric Power Device
rr ; n�•� %�-r� ,�/V � 7�- 7c% � � 7. Geo[hermal Energy Heating/Cooling Device
Ciry, Smu ZIP Cade Counry
� � 2. Does the buyer have a homestead in Indiana to be � �$• �s this property a residential rental proper[y?
vaca[ed for [his residence? If yes, provide ❑ � 9. Wouid you like to receive tar sta[ementr for [his
comple[e address of residence being vaca[ed, property via e-mail? (Provide contoct informadon
including county: below. Please see inshvciians%r more informa[ion.
Not availa6le in all coundes.)
Addres(NvmberaMSbee[) a� ia /5 ���z/ a l/� /
[iry, Smte ZIP lade Counry
Pnmarypmperryawnerronmrtname E-mail
Under penal[ies of perjury, t hereby certlfy that this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse informa[ion, ocial Security and Driver's License/Other numbers are not necessary if no Homes[ead Deduc[ion is
being � �
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S' iomre Buyerl S' a a(Buy�er2/Spouse
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Pnnled alNameofBuyerl SignDare(MM/DD/YYYY) Pn'n[edLegalA'ameo/Buy�2/Spouse � nDate(XM/DD/YYY17
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LastSdigiao�Buyer]Driver's 5[ate LastSDigi[so(SocialSecurityNumber LastSdigifso�Buyer2/SpouseDnver's Smfe Las[SDigiCSOSocialSecurity
License/ID/OtherNumber Num'er License/!D/OtherNumber