Homestead_McKowenINDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
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Laura Rininqer Cbsinq Coordinator
Pnpemro%the5ata0kclmurcForm Title
7820 Eaale Crest Blvd Ste 201 Regional Title Services LLC
Addr�s(NumberandSveeQ lompany
Evansville IN 47715
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rE�SEI:IER S' GRANT,OR S,c•°�,a;$i'��,ii�.. ''���'��A '��i�'.�.s�"����'nrs.ik�'x�+� �.E�� °�`w'.�4`:i'"2��'",i��'�,`*'.4�A j�.�`r'h'�
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Seller 1,� Name as appears on conveyanre dacumm: Sellcr I- Name as appearz om m�veyanre docummt
10016 S Partfidae inm� c PaAririBP
Addrm' (Number a�dSvreQ Address (Num6er and Sbeet)
Na hctadf IN d7R44 Hanhcr�rit IN d7F9Q
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Under penalties of perjury reby cer[ify that this Sales Disclosure, to the best of my knowledge and belief, is true, corred
and cm te as re ire y law, and is prepared in accordance w� 6-11-5,5, "Real Pro rty Sales Disclosure AcY'.
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Thnmae R hao�+ .Ir O1I1U2013 r:�nnfe � f1aa� Ol/ll/2013
Prin[edNartxofSe➢er SionDale .aK/DD/YYF Mn'sdilamra Sefler Si nDate M.4/oD
�F..B ` TEE S iAP.P,LI6ATI0N'FORiP.ROP.ERTY,�TAX�DEDUGTIONS'-;IDBNTIF,P-ACLITEA9SsTHAT:APPLY�_� ��::;:"`'.� ��Y
Nolan l. McKowen Lisa R. McKowen
conveyonre dotumm[ Buyrr 2- Name as oppears on rmveyanre dotumen[
307 SW 12th Aot 7C 301 SW 12th Aot 7C
Address (Number and StrcetJ Addrexs (h'umberand Sheet)
Fairfield. IL 62&37 Faihetd. IL 62837
Ciry, Smte. and ZIP Cade Ciry. Smte. and ZIP fade
Tele M1aneNumbei E-mall Tele F.oneNumber E-mail
TXE SALFS DISCLOSURE FOR.N M1L1Y BE USED T0,IPPLY F00. CERT.Uti DEDUGTIONS FOR THIS PROPERTY. IDEpTIFY ALL OF TNOSE TNAT.IPPLY.
YFS NO CO\DITION ��
Q � 1. Wilt [his property be [he buyer's primary ✓ � 3. Homes
residence? Provide complete address of primary ,/ 4. Solar Energy Heating/Cooling System
residence, including county: � � S. Wind Power Device
t0016 ` Partridgp ) � Q 6. Hydroelectric Power Device
Address Numarrand5treet
Haubstadt IN 47639 Gibson � � 7. Geothermal Energy Heating/Cooling Device
Clry, Smte ZIPCoEe Cour,ry
� Q Z. Does the buyer have a homestead in Indiana to be ❑ ❑`� $• �s this proper[y a residential rental property?
vacated for this residence? Ifyes, provide ❑ �✓ 9� Woutd you like [o receive tax statements for this
complete address of residence being vacated, property via e-mail? (Provide contoc[ injormodon
including coun[y: below. Please see instructions%r more information.
Not availa6le in all counlies.)
Address (Number and SveeQ
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Ciry, Smre Z(P lode Cour.ry
Rtmary praperry owner mnmc[ name -mail
Under penal[ies of perjury, I hereby certlfy that [his Sales Disclosure, to the bes[ of my Imowledge and belief, is true, correc[
and complete as required by taw, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclasure Act". (Note:
Spouse informatlon, Social Security and Drivers License/Other numbers are no[ necessary if no Homes[ead Deduc[ion is
beingfled.)� /�� � '/
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Signamre of Huyerl Signamrc o('By�er2/Spouse
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License/!D/OtherNum6er Number License/ID/OtherNumber
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