Homestead_Perry (3)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D. �'QEPARER � ' ' - -
Sherri S Hudson Closina Aaent
Preparer o([he Sales D'¢dosure Form TiHe
605 SE MLK Jr Blvd Southwestem Indiana Land Tiile Inc.
Addr¢s(NumberondStrcetJ Company
Evansville. IN 47773
E-mail
E.SEGLER S GRANTOR S': ".:"- - .. -,- _. _: ; , s-� . : � . . .�,. - ,� ._.
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SeIler ]- Nome as appears om m�veyvnce documm[ Selle� 2� Name as appeors on ronvryonre documml
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Addr¢s (Numbrr ondSmxt) Addr�s (Number end5veetJ
Fnrt Branch IN 47R48
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Under penalties of perjury, 1 hereby certify that this Sales Disdosure, [o the best of my knowledge and belief, is true, correc[
and yqmplete as requ'r�� a�v, and is prepared in accordance �vi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Ac[".
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F. BUYER S� GRA�TEE S- AFPLICATION FOR PROPERTY TAX DEDUCTIONS-1DENTIFY ALL ITEMS THAT APPLY: •�',_': °' "<'t
Timothy Perty
Buyu 1- Name as appears on ronvryanre dxumm[ Buyer 2� Name as appears on ronveyance doaumen[
4565 Hiahway 7 7
Add�ea (Number and50-ee[J Add�cs (Number and Stree[)
West Salem. IL 62476
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THE SALFS DISCLOSURE iORM MAY BE USED TO APPLY FOR CERTAI V DEDUCf10YS FOR THIS PROPHRTI'. IDHhTIFY ALL OF THOSE THAT APPLS'.
VES 60 COYDITIO\ I YFS NO COYDITIOY
� 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary � Q 4. Solar Energy Hea[ing/Cooling Sys[em
residence, including county: � 5. \Nind Power Device
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Addr¢s(NUmbesandStreeQ � Q 6. Hydroelectric Power Device
ro?r �; �..-„ c'6, -Sh� .:/7�yk �� �?'im1_ , � O 7. Geothermal Energy Heating/Cooling Device
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� � 2. Does the buyer have a homestead in Indiana [o be � - 8� �s this property a residen[ial ren[al property?
vacated for this residence? If yes, provide ❑ ❑� 9. Would you like to receive [ax sta[emen[s for [his
complete address of residence being vacated, property via e-maiR (Provide mntact information
induding county: 6elow. Please see instructions for more informaCion.
Not available in al( counties.)
Address(NumberandSVretJ N/„� /� -i3 -yo3a� d/6 �a,�
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Pnmary p�operry owner mnmrt name E-mail
Under penal[ies of perjury, t hereby certify tha[ [his Sales Disclosure, [o [he bes[ of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/O[her numbers are no[ necessary if no Homestead Deduction is
beingfiled.) n �
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Number Las[ 5 digitt o(Buyer?/Spouse Drlver's Sta[e Last 5 Digits o(Sotial5ecurity
License/lD/O[herNum6er Number License/fD/OtherNumber