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Homestead_Gayso (2) 1 INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 - a:D ERE P,ARER.`=.�T� o_^ r� -" --te - . - c- -r a r- - .s+r -^T: ` c'. 7- "- _.4_x_T-r : Scott E. Lance Title Agent Preparer of the Sales Disclosure Form Title • 600 N.Weinbach Ave. Foreman Watson Land Title Address(Number and Street) Company Evansville IN 47711 , 812-402-4555 slancec thv-It.com City,State,and ZIP Code Telephone Number E-mail ;E SEu ER(S]%GRANTOR(S).zt'_ _-_ . F _.,.. _.. _ :;.. sue_ .6- .71_77.77.- - = `- '- `= --277:.. Amy R Ri7en(faa Amy R Neufelder)1 Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1777 Shoreline Dr Aottt 211 Address(Number and Street) Address(Number and Street) Telephone Number E-mail Under p (ties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and coJrdplkte as requi by w,an is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". fignatureeooff Seller• 1./ Signature of Seller Aryl. . P;2Pt2 3/tal j3__ I Printed Nafie ofSellen. 1 /—Sign ate(MM/00/YYYY)._ 1 Printed Name ofSeller Sian Date(MM/OD/YYYY) _ .:IBUYER(S)%GRAN, (S)' APP.LIGATIONFOMOP.ERTYTAXtT)EDUCTIONSIU)ENTIF.YALIATE'MStTHAT.AP,PLY,, _ ' Kyle A. Gayso Buyer l-Name as a•• s on conveyance document Buyer 2-Name as appears on conveyance document 20 . •a -- Address(Number and Street) Address(Number and Street) Owensville IN.47665 Telephone Number E-mail THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION • NO CONDITION Q ❑ 1.Will this property be the buyer's primary igi n 3.Homestead residence? Provide complete address of primary In M • - . ° ergy Heating/Cooling System residence,including county: ❑ E' S.Wind Power Device 207 S Oak St Address(Number and Street) ❑ r' 6.Hydroelectric Power Device Owensville 1 .47665 Gibson ❑ n 7.Geothermal Energy Heating/Cooling Device City,State Code County �{ Or ( 2.Does the buyer have a homestead in Indiana to be ❑ LJ 8.1s this property a residential rental property? vacated for this residence? If yes,provide ❑ d 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) Q {W 'Al-,2 -0.01°,1 City,State ZIP Code. Counry Primary property owner contact name 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 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 mg filed.) . �� Signature a er1 Signature of Buyer2/Spouse I< I A A . r~yso 3j/VA? Number License/ID/Other Number