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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER`... . _? . _ `'$ s s e v.o °`3 v x '•'` r
Laura Rinincier Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Tille Services,LLC
Address(Number and Sweet) Comparry
Evansville, IN 47715 812-759-5555
Clty,State,and ZIP Code Telephone Number E-mail
E.SELtiER(S)%GRANTOR[S).. ' ,
Thomac I Naas dba Tom Naac Homes -
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
897E1200S
Address(Number and Street) Address(Number and Street)
Haubstadt. IN 47639
Telephone Number 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 corn tete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
n•;,:L9 \-- I / 1
• nted Name of Seller Sian Date(MM/DO Printed Name of Seller Sian Date(M.M/DD/IYH)
.BUYER(S)/GRANTEES):APPLICATION-FOR PROPERTY: DEDUCTIONS-.IDENTIFY•AL• ITEMS THAT APPLY- •---. • . :
an W.Cantner Breanna K.Cantner
rer)-Name as a- -• on conveyance document 2-Name as appears on • •eyance document
•1 .SR165 e . - •
Address(Number and Sweet) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIO " OR T. SPROPERTY. IDENTIFY ALL OF THOSE THAT •- LY.
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of prima _u , • ar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
439 E Hirsch Woods I ane
Address(Number and Street) ❑ TA 6.Hydroelectric Power Device
_Haubstadt, IN 47639 GIBSON p is 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IN 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) OA(-07s-0 2-aye°. w/
/7.5--671V
City,State ZIP Code County
Primary property owner contact name E-mail
Ny
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