Homestead_Anderson (6)INDIANA SALES DISCLOSURE FORM SDF t
Tiffanv Hoon Closing Services
Preparer o(the Solu Ditt'/nsure Form Title
7820 Eaqle Cresl Blvd Suite 201 Reqional Title Services LLC
Addms (Numberand 5[ree[) Company
Evansville IN 47715
mall
Seller 7- Name as appenrsom m�veyvnce donrmen[
117 S leffercon St
Addres (Number and Stree[)
Prinroe.,n ini e7570
City, Smre, ond ZIP Lode
TeleohoneNumber E-mail _
Seller2 - Name as appears om m�veyance dxumen[
Addres (Number and StreetJ
City. Smte, and ZlP lode
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and cqpiple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disdosure Act".
on ronveyanre dacument
Princeton IN 47670
Ciry, Sru[e, and ZIP Code
THE SALFS DISCLOSURE FOM1 AL1Y BE USED TO APPLY FOR CERTAIN DEDUCf10N5 FOR
✓� � 1. Will [his property be the buyer's primary ��
residence? Provide comple[e address of primary
residence, including county:
fi7�R S 1050 w
Addrea (Number and Street)
Owensville IN 47665 Gibson
Ciry, Srnte ZIP Code Cowry
��✓ 2. Does the buyer have a homestead in Indiana to be
vacated for [his residence? If yes, provide
complete address of residence being vacated,
including coun[y:
Addrea (Number and StreetJ
Ciry, Smte Z/PCode County
5(gnamre o(Seller
euyer 2� A'ame as appwrs on ronveyanre docvment
Address (A'umber ond Streef)
City, Slale, and ZIP Code
✓� � 3. Homestead
❑ ❑✓
❑ `�❑
❑ `�❑
❑ ✓❑
Heating/Cooling System
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Hea[ing/Cooling Device
8. Is this property a residential rental property?
9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
6elow. Please see instructions for more information.
Not available in all counties.)
�?l _�� /% �oo .�0o.7.3a-o�
mntoa name
E-mail