Homestead_Hale (2)DISCLOSUREFORM SDFID:
D.PREPARER
Christa Kinasburv
Preporerof(he Sale D'uclosure Form
Addr¢s (Number andSVret)
rm�
Company
Evansville IN 47708
E-mail
lav M Ayrrc
Seller 1� Nameas appevrs on ronveyanre docvmen[
Addras (NUmberand Stree[)
Se/!er 2� Name as appevrs om m�veyance davment
Addrecc (NUmber and StreetJ
Hanhctadt IN 47639
Ciry. Stufe and LPCade Ciry. Sm[G and ZIPCode
TelephoneNumber E-mail TdeOhoneNum6er E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, t the bes[ of my knowledge and belief, is true, correct
a/n e as requ�irjed by la �s prepared in accordance wi[ 6-1.1-5 ,"Re roperty Sales Disclosure Ac[".
Signam`\� .V�C /�� i naa�eof eller
�1
YES YO COYDITION
�✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
Addrecs (Number and StreetJ
Haubstadt IN 47639 Gibson
[iry. Zlv[ode [ounry
� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
comple[e address of residence being vaca[ed,
�o�c�`�'�p�ri� ��►�
rss(Xumbc ndStr
ua "�a � ��� \Ica�,
Ciry. Smtt LP Cade Counry
Ciry. Sm[e, and Z/PCade
❑ ❑�
❑ ❑�
❑ ❑✓
� �
❑ ❑`�
3.H
APPLY.
Energy Heatlng/Cooling System
S. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Hea[ing/Cooling Device
8. Is this property a residential ren[al proper[y?
❑ ❑✓ 9. Would you like to receive tat statements for this
property via e-mail? (Provide contact informatlon
below. Please see ins[ructians for more information.
Not availa6le in all countles.)
oT� �_3 - CJ�7- 4�`� -o0�?./6�-p�i`�
Number Lirense/ID/Other Num6er
a5 �