Homestead_HarrellIYDIA\ASAI.ES DISCLOSURE FORil1 SDFID SDO ID 1597779 Page2
D.PREPARER •
Judy Williamson Mortgage Loan Closer '
Preparer o(the Sales Discfosure Farm lltle
4401 Theater Dr. Evansville Teachers FCU
Addrm'(A'umEerandStmeQ Company
Evansville, IN 47715-
E�mail
E. SELLER S GRi1NTOR S - -
Mark Bresnahan
SeAer 1- Nome as apyears on rom�eyance datummt Seller 1� Name os oppcnrs on ronveyanre daavmmt
6745 West 400 South
Addres 1Number nnd SveeQ Address (Number ond Sveey
Owensville, IN 47765-
Cin.Smtz andZfPCOde Liryt Sm[e, ond'LIPCOde
Tele honeNum6er E-muil Tele honeh'umber E-mail
Under penalties of perjuryil hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and tomple e as requirjed;by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
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F. BUYER S GRANTEE S-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFYALL ITEMS THAT APPLY
lisa D. Harrell
Buyer }- h'ame rs apytars on tonve}vnt'e davment Buyer? - Kome as appearr om m�veyvnae do�vmm[
6745 West 400 South
AdCres (Num5er and Svret) Addrecs (h'um6ermd Sbee[)
Owensville, IN 47765-
Tde oneNum6er E-mail Tefe oneNumbe� Email
TNE SALES �ISCLOSURE iORhf NAY BE USED TO APPLY FOR CERTAI.Y OEDUCfiONS FOR THIS PROPERTY. IDENTIFI' ALL OF TNOSE THAT APPLY.
1'ES ND COADITION 1'ES NO COAOITION
X� � 1. Will [his property be [he buyer's primary �x � 3. Homestead
residence? Provide comple[e address of primary � � 4. Solar Energy Heating/Cooling Sys[em
residence, induding county: ❑ �
6745 WEST 400 SOUTH 5. Wind Power Device
Address(NUmberand5vee[) ❑ Q 6. Hydroelectric Power Device
Owensville, IN 47765 GIBSON
❑ Q 7. Geochermal Energy Heating/Cooling Device
Ciry. Smte ZIPCOde Counro
�� 2. Does [he buyer have a homes[ead in Indiana [o be � Q g• �s [his property a residential ren[al property?
vacated for this residence? If yes, pro��de ❑ Q 9.1Nould you like [o receive tax statemenCS for this
complete address of residence being vaca[ed, property via e-mail? (Provrde con[act informotion
including county: below. Please see instrucdons for more injormation.
Not availab(e in oq counties)
Addrets (Number and Stree[)
a b- �a -��-z oa - o0 3. So �-oa �
Ciry. Slate IIPCoCe Counry
Pnmarypropertyownermnmatname E-mail
Under penalties of perjury, 1 hereby certi(y that this Sales Disclosure, [o the bes[ of my� knowledge and belief, is [rue, wrrec[
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "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 )ed.)
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gnomre o(Bu}'eN Signamre af Buyer2/Spouse
Pnb[edLegolNameofBu}refl SignDate(NM/DD/YYn) Prinredl.egalNomeo/Bvyer2/Spause SignDare(MM/OO/rYYY)
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Los[SdigiGSOfBu}'er}Driver's Smte Las[iDigiaof5otialSecuriryA'um6er LoslSdigicsofBuyer2/SpauSeDriver's Stu[e LaslSDigiGSO(Sa'ialSecurity
6itense/ID/OtherNumber Num6er Gicense/1D/OLherNumber