Homestead_MartinCHRISTINA LATHAM
�a -oarer of the sales Disclosure Farm
THEATER DRIVE
arm (Number and Street)
EVANSVILLE IN 47715
city, State. and ZIP Code
Seller I - Name as appeurs on conveyance document
96 9z C ma
Address (Number and Street) 14 ?660
�V,IU118 e:E TV.
n'0; Swa,, and ZIP (,ode N I
TITLE CLERK
Title
REGIONAL LAND
Company
r�Seller 2 - Name as appears on conveyance document
- IIO�ti
Address (Number and Street)
0 CI IN elljlro
C(ry, state and ZlP ode I�
E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best , "Re knowledge and belief, s true, correct
and pie re`��gqu�iired by law, and is prepared in accordance wflyrul llvyl-NS,�R� Property Sales Disclosure Ad ".
�/� i'//G�y I
Sonamre al seller 511 qgo i s
jgnamre of seller
D fMM/DD/YYYt1
- Name as appears on conveyance document
I - Name as
Address
State,
State. and ZIP Code
and Street)
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
I .._ ..,. mcnmfYN
1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
699 E MAIN S
Address (Number and Street) G IBSON
OAKLAND CITY IN 47660 Counry
City, State ZIP Code
2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
(Number and Street)
/ A-
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3. Homestead
R
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4. Solar Energy Heanng /Cooling System
S. Wind Power Device
Q✓
6. Hydroelectric Power Device
El
n
7. Geothermal Energy Heating /Cooling Device
Q
B. Is this property a residential rental property?
❑
Q
9. Would you like to receive tax statements for this
property via e- (nail? (Provide contact information
below. Please see instructions for more information.
BENJAMIN D MARTIN
n -mots
Under penalties of perjury , t hereby certify that this Sale
, s Disclosure, to the best of my knowledge and belief, is true, correct 1 -5.5, "Real Property Sales Disclosure Act ". (Note:
and complete as required I law, and is prepared in accordance with IC 6- 1.
Spouse informati n, Soft ial Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
be filed.)
_� � - / � I Signamrea(Bwed /Spouse
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ignareofBayerl C
. Sjgn Dae (MM/DD/YYLN.
I Number 5 digits ofBuID% lSpous Number State LastSDigics ofSocial5ecuriry