Homestead_Brown (27)�1NDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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LANA C. HARPER CLOSER
rTeparer of the Sales Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES LLC
Address (Numberand Street) Company
EVANSVILLE. IN 47708
E-mail
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WEBER INVESTMENTS, LLC
Seller 1- Name as appears on conveyance document Seller2 - Name as appears on conveyance document
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A dress (Num6er and Street) Address (Num6er and Street)
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E-mail Tele 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
a omplete as req�ed by law, and is prepared in ac rdance with [C 6-1.1-5.5, "Real Property Sales Disclosure Act".
Signa[ure afSeller Signa[ure ofSeller
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Printed Name o Seller Si n Date MM DD Prin[ed Name o Seller Si n Date MM DD
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JARON BROWN
Buyer 1- Name as appears on conveyance document Buyer Z- Name as appears on conveyance document
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A ress (Number and Street) Address (Num6er and StreetJ
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City, State, and ZIP
Tele honeNumber E-mail Tele honeNumber E-mail
THE SALES DISCLOSURE FORM MAY BE OSED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
� 1. Will this property be the buyer's primary �❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
esiden including county: � �
/ � � � 5. Wind Power Device
r/s(Numbe andStreet) ./,/� j .O� ❑ �, 6. Hydroelectric Power Device
/1(e ._l�. 7��/ 7 iJ �_ � [Y� 7. Geothermal Energy Heating/Cooling Device
City,S[ eZPCode County
�� 2. Does the buyer have a homestead in Indiana to be �� 8• Is this property a residential rental property?
7�� vacated for this residence? [f 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 counties.)
Address(Num6erandStreet) .a3o oa
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City, State ZIP Code County ,
Primary property owner contact 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, So ' 1 Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being f .)
Si aGUre of Buyerl Signature ofBuyer2/Spouse
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Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits ofSocial Security
License//D/OtherNum6er Number Llcense//D/OtherNum6er