Homestead_HansonINDIANA SALFS DISCLOSURE FORM SDF ID: Pa e 2
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CHRISTINA LATHAM TITLE CLERK
Preparer o(N¢ Sala Dkdasvre Fortn TiHe
4703 THEATER DRIVE REGIONAL LAND
Addrm(Numberand5treery Company
EVANSVILLE IN 47715
=E:SELtiER S .GRANTOR S �: `T ° -, - f'` r•- " : ., - -, r�
TERESA R SMITH
Se!!er 1- Name as appears an ronveyance docvmen[ Seller 2- Nome as oppears on conveyunre docvment
104 E FOSTER ST �
Addras (Nvmbe�and Street) Addras (Number and Street)
FT. BRANCH IN 47648
E-mail Tele honeNUmber 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 wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Act".
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TERESA R SMITH °�I �l � � 3
Pnh[edNamea Se/le� SiqnDate MxryD PnntedNamea Seller SiOnDale(MH/DD
iF:;6UYER S � GRANTEE S �C'-`�AP.PLICATION�F,OR�PROPERTY:TAX DEDUCTIONS-�dDENTIFYAI`GITEMSeTHAT.APPLY�:.:'';_ ' _ . .``?�•_ �':,��;
KYLE S HANSON
Bvyer 1- Name os a➢pmrs on ronveyance dotument euyel2- Name as appears on ronveyantt document
104 E FOSTER ST
Addr� (A'umberand So-en) Address (NUmber ond Street)
FT. BRANCH IN 47648
Email Tele honeNum6er E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAI.Y DEDUCfIONS FOR THIS PROPERTY. IUEYTIFY ALL OF THOSE THAT APPLY.
YES NO COSDITIOY I YES HO CO\DITIO,�'
❑./ ❑ 1. Will this property be [he buyer's primary Q � 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
residence, induding county:
104 E FOSTER ST ❑ ❑✓ S. Wind Power Device
Addrns(Numberand5treetJ ❑ ❑✓ 6. Hydroelec[ric Power Device
FT. BRANCH I Y47648 GIBSON � � 7. Geo[hermal Energy Heating/Cooling Device
c�.y,smuz�v e co��ry
� 2. Does the buyer have a homestead in Indiana to be � ❑`� 8• �s this property a residential rental proper[y?
vacated for [his residence? If yes, provide ❑ ❑✓ 9. Would you like [o receive [aac sca[emenCS for [his
comple[e address of residence heing vacated, property via e-mail? (Provide contat[ in%rmation
including munty: 6elow. Please see instrucdons for more informadon.
Not available in all countles.)
Addras (Number and StreetJ a f0' � a' Z�• 2 �^L ' Q� �. � Q� •� p� `
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KYLE S HANSON NA
Clty, SmteZlPlode County
Pn'maryproperryawnertonmciname E-mai!
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/O[her numbers are not necessary if no Homes[ead Deduction is
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KYI F C HANSCIN /1 � 7 I� � 3
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