Homestead_WilkersonINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
�D::PREPARER���, ,.� �'�- -•. - " „_ .;� .. :' 4 _�-,.-��._�-- _,:._-�� . - - - �<-� ' -
CHRISTINA LATHAM TITLE CLERK
Preparer of rhe Sala Disdosure Form Title
703 THEATER DRIVE REGIONAL LAND
Addrns (NUmber and SveetJ Company
EVANSVILLE IN 47715
E;:SECLER S GRANTOR S - ` - = ' - { - _ � - -
`-
invr� i itqYS
Seller7 - Name as appmrs am m�veyanre documen: Seller 2- Name as appevrs on rnnveyance document
��o c �nrni oecu ST
Addrrss(Numberand5veetJ Addres(NumberandSVeeQ
PFRI I IN 46q70
liry, Smte, and ZIPCade Ciry•. Sm[G and ZIPCOde
E-mail Te/eohoneNumbrl E-mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6•1.1-5.5, "Real Property Sales Disclosure Act".
Sgq n eo !er v S�qnamrea/Seller
invi� i KAYC A ���'�/��
RintedNameo Seller SionDatefHa/DD/Yn'Y7 Pdn[edNameof5eller SIOOD0t4(NHND
:;F: BUYER S GRr1NTEE S-.AFPCICATION�.FOR�PROP.ERT;Y TAX�DEDUCTIONS-�IDENTIEY:Alili?ITEMS THAT�APFLY.�` -_
JOSHUA A WILKERSON
Buyes I- Nameos appeirs om m�veyonre docvment Buyer 2- Name as oppears om m�veyance dotummc
201 S FIRST ST
Addrgs (A'umber and Stree[) Addras (NUm6er ond SneetJ
WENSVILLE IN 47665
Ciry. Smt4 and LP Code Ciry, Sm[e, and ZIP Code
� �j
TeleohoneNUmber E-mail Tele honeNumber E-mail
THE S1LFS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIK DEDURIO\S FOR THIS PROPERTY. IDE\TIFY ALL OF THOSE THAT APPLY.
YFS YO CO.�'DRION I YFS NO CO\DRIOY
Q � 1. Will this property be the buyer's primary Q ❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Hea[ing/Cooling System
residence, indudin� county: � � 5. Wind Power Device
om c qRGT ST
Addras(Num6erandSaeetJ ❑ ❑✓ 6. Hydroelectric Power Device
OWENSVILLE IN 47665 GIBSON � Q 7. Geo[hermal Energy Hea[ing/Cooling Device
Ciry. SmteZlPlode Counry
� � 2. Does the buyer have a homes[ead in Indiana [o be � ❑� 8• �s [his property a residenrial renWl property?
vacated for this residence? If yes, provide ❑ ❑� 9. Would you like to receive.taac sta[emen[s for [his
complete address of residence being vaca[ed, property via e-mail? (Provide contoc[ informadon
induding munty: below. Please see instrucdons for more information.
GNot avoilable in all counties.)
Addras(NumberandStreeQ ���� p •0� �0 / 4�0 ��� �a�/
JOSHUA A WILKERSON ✓f�4
Ci.y, SmteZ/PCode Lounp.
Pnmaryproperryavnerconmt[name E-moil
Under penalties of perjury, I hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, is [rue, correc[
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Proper[y Sales Disdosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
bemg d.)
-��, �,;.��-
� Signa eofBuyerl i/ ) Sfgnaareojeuyer2/Spouse
u in e�n� �cocnni 7�� ��'� L�
p��� ���
Las[Sdigicso�Buyer?/SpouseDriver's Srace Las[SDigi[soJSocial5ecurity
Lirense//D/OrherNum6er Num6er Lirense/!D/OtherNumber