Homestead_Julian (2)INDIANA SALES DISCLOSURE FORM SDF ID: Pa
D:`PREPARER -
Don Dowell Regional Manager
eporer ofthe Sales Disclosure Form Title
07 N Green River Direct Title Insurance Agency, Inc
Address (Number and Street) Company
Evansville. IN 47715
E -mail
5E:'SEGCER S GRANTORS t ='' ' "
The stat of Ruth V. Page. ViMinia Elaine Waller. Co-Pers. Rep_
The Estate of Ruth V- Page- Kenneth Wayne Page. Co-Pers- Rep_
SellerlName as�y pears on ronveyance document
Seller 2 -Name as ap➢ on ronveyance document
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(Numb�e�rs,(q�of
y�d�djre�u) (Number and(n et)
��Jirr. �Stre�et)
WILL ry LI r � 1 ....1-,Y, 47It% C)
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city, State, and ZIP Code
City, State, and ZIP Code
E -mail
Tete hone Number E -mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required bylaw, and is prepared in accordance with I 6- 1.1 -S.S, "Real Property Sales ' closure Act ".
Signature ofSel/er 'Signature afseller
Viminia Elaine Waller 05/28/2010 Kenneth Wayne Page 05128/2010
Printed Name o Seger Sin Date (MMIDDIYYYn Printed Name oFSeller Sian Date MM D
,F:-BUY GRAN -`APPLICATION FOR PROP.ERTY:TAX DEDUCTIONS = IDENTIFY.ALL ITEMS THAT APPLY%•; " " ' y
t ven R. Julian
Buyrrl -A'ame as appears on ton rice document
Buyer2 Name as appears on conveyance document
Address(A'umber an beet )
Address (Number and Street)
akland Citv. IN 47660
.7ry SW M and Z/PCOde
Ciry• State, and ZIPCode
Telephone Number E -mail
Tele hone Number E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITIO.
❑✓ ❑ 1. Will this property be the buyer's primary
❑✓ ❑ 3. Homestead
residence? Provide complete address of prim
gy Heating /Cooling System
residence, including county:
❑ ✓ 5. Wind Power Device
240 West Morton St
❑ ❑6. Hydroelectric Power Device
Address (Number and Street)
Oakland City. IN 47660 Gibson
❑ ❑✓ 7, Geothermal Energy Heating /Cooling Device
❑ ✓ 8• Is this property a residential rental property?
City, Smte ZIP Code coaa ry
❑ ❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ ❑✓ 9. Would you like to receive tax statements for this
complete address of residence being vacated,
property via e-mail? (Provide contact information
including county:
below. Please see instructions for more information.
Not available in all countiW
�s /1
J6 _ /4-/g, 161-606. 03-607
T v
Address (Number and Street)
Steven R. Julian
Ciry, State ZIP Co de County
Primary properly owner mnurct name E-mail
Under penalties of perjury, I 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 ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.) n
Signatureofavyerl a SignatureofBvyer2/Spouse
w n R II lion OSI2RI2010
LastSdigitsofBuyerl Driver's State Last S Digits of5ocial Security Number Last 5 digits ofBuyer2 /Spouse Driver's State Last 5 Digits of5ocial Security
license /I010ther Number Number License /ID 10therNumber
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