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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.P,REP3Eit`s -=.`
DENISE HAYDEN TYPIST
Preperer afthe Sala Disdasnre Form 79de
530 FREDERICA STREET FOREMAN WATSON LAND TITLE
Addreu(A'umbercd Street) Company
OWENSBORO. KY 42301
_ Email
E. SEL 13 CRY NTOR '. a M ' 0.s` M'MXM - _M-_
THE =STATE OF CAROL J SHERIDAN
THE ESTATE OF CAROL J SHERIDAN
Seller:- Ncmea=C� ears or. can:elv�ocJgent /
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Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowled a and belief, is true, correct
and complete as required by la v, a is prep ed in accordance M S,/$enj Prope lQ§ Disclosure Act ".
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TERFSA ANN KIESF CO- PERSONAI REP 0811 8120 1 2 DAVID JOHN KI SEI ,O-P RS NAt REP MI _12
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JERRY A. FREEMAN
Buyer I jcea vaavment
PuyeZ ;leme as epparz on mnveycna docum<nt
102 S. VINE STREET
4ddres (Number and Street)
Addrv�(NU.+rber and Saee =) .
HAUBSTADT. IN 47639
Cirj, Smt_, and ZlP fade
liy, State and ZIP Lade
Tale hone:Yumbcr E-mail
rele hone Number Email
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
IFS NO CONDITION I YES NO CONDITION
❑✓ ❑ ',.Will this propery be the buyer's primary
Q ❑ 3. Homestead
residence? Provide complete address of primary
❑ 0 4. Solar Energy Heating /Cooling System
residence, including County:
(} f n Q, -f"i^
❑ ❑s. Wind Power Device
❑ ❑✓ 6. Hydroelectric Power Device
„b<ramI S &W.)
� TN 7
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❑ ❑7. Geothermal Energy Heating /Cooling Device
❑ S. is this property a residential rental property?
City, Stcar ZIP Cse
F-1 Q 2. Does the buyer have homestead in Indiana to b�
a
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 a -mail? (Provide contact information
including county:
below.. Please see instructions far. more information.
Not available in all counties.)
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Addressee
I �� -t3 / --30 3 0do
CIr�Smte LPCOde Cour. ty
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PrLmmy property owner mrmaneme E -matt
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 -)
s*m.re ,a,, Signature ofBVee2/SPauu
JERRY d EREEMAN nenannl2 -
PrintedLegalA'ameofBuyerI Sign
LastSdigitsof9uyerl Dneer's State Last 5 Digits ofSocfal Security Number Last 5 digits of Buyer2 /Spouse Driver's State Last 5 Digits ofSocla15ecurity
License/ID /Other Number Number License/ID /Other Number
