HomeMy WebLinkAboutHomestead_Svestka INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Angie Pace Title Assistant
Preparer of the Sales Disclosure Form Title
1911 Lincoln Ave. Clear Title Company
Address(Number and Street) Company
Evansville,IN 47714 812-423-8854 etc{ sigecom.net
City,State,and VP Code Telephone Number E-mail
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E.$H[L'ER(S)%GRAIrTOR(S) ;�ri;'�3 �.�_° . �. �;'7`�` �.,�`e-._,e.s_:-_ '`�, ��r,r�?€ r�. _ �,.=.iv�. s�z,._��_
- e. : :es!-. Christine M Rogers
Seller 1.Name as appears on conveyance document Seller 2-Name as appears on conveyance document
I55 E S icc rsi 5
Address(Number and Street) Address(Number and Street)
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Und: penalties o .: jury,I hereby certify that this Sales Disclosure,to the b-s of my knowledge and belief,is true,correct
an. comp - : . jo• b aw,and is prepared in accordance with I. 6--.1 -,"Real Proper .ales Disclosure Act°.
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3—ASNe.1 • i -.eels 032-42013 �• L is Le �_ _ 3 • -
Fria-. ...earn � Sign Date(Y.N/OD/117Y) Printed Name o(Seller Son Date Ns/Do/7m
f_ DYER S `,GRANTEE S j-tAPPLICATIONIP.ORi PROP•ERTYpTAX.DEDUG TIONS'IDENTIFY°ALCITEMSiTHATfAPPLY " ' _;_;, )
4 Amy Viminia Svestka - - - -
Buyeri-Name as app • conveyance document Buyer 2-Name as appears on conveyance document
-. -ace St.
rat Address(Number and Street)
Princeton,IN 47670
THIS PROPERTY.IDENTIFY ALL. eIOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of or! MI u . • . nergy Heating/Cooling System
residence,including county:
777 S Race Stre=i II CI-5.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton,IN 47670 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
ay,Sate ZIP Cyr County
❑ Does the buyer have a homestead in Indiana to be ❑ Q 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ B.* 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 a counties.) ///'''
Address(Number and Street) (�n/t //11 OD �S ass-O4
City State ZIP Cade County ""� '/��� V/ e/✓! CCC///
Primary property owner contort 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
bei,,,ii`
filed.�> -
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ignatur-ofB,y,hfrl s Signature ofByer2/Syoue
`A -- t%n(a &es & 32B/5
' -' ''' Number License/ID/Other Number
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