Homestead_Fuhs INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D BREPARER `- '" '- -, rL
LANA C. HARPER CLOSER
Preparer of the Sales Disclosure Form Tide
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES,LLC
Address(Number and Street) Company
EVANSVILLE. IN 47708 812-468-8485
City,State,and ZIP Cade Telephone Number E-mail
;E:SELLER L -' - ::. - -.- - - -> -.- : . .•
GARY W RICHARDSON JANE ANN RICHARDSON
Seller 1--Name asappearsann conveyance document , Seller 2-Name as appears on conveyance document
2—Th0 C.1 ^ .ta. i 6 iSc, £Z.-g30fo - o6?DRJsb
Addr (Nu rand Street) A Address(Number and Street)
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 require law,and is prepared in accordance with IC 6-1.1-5.5,"Real Pro erty Sales Disclosure Act".
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Signature o�ler Signa a of Seller
Ia'lliry vkJ , 4' 1 c)-( AOZE2Soit" V�17J1� JRA)6 Ann J(-hardsort. V/1 / 3
Punted Name of Seller Stan Date MM/DD/Ylm Punted tame of Seller Sian Date(MM/OD/CM)
LE BUYER(SPGRANTEE(S), APPLICATION,FOR 1ROPERTY<TAX'DEDUCTIONS IDENTIEYA'LL,FFEMS;THATiAPEGY
KENT D. FUHS
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
32I ■,.) Chcrry Ski-trvF-
Address(Number and Street) Address(Number and Street)
® Oo.c3 e•6- C1#N L-I l(Din0
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
Y� NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary F ❑ 3.Homestead
residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System
residence,including county: ❑
&93o 6 SR Sto 5.Wind Power Device
Mires(Number and Street) (Pie ❑ 0 6.Hydroelectric Power Device
YT AZ£L�N 1 A) ( !(o ye 6/650N ❑ Fl 7.Geothermal Energy Heating/Cooling Device
City,State Code County
❑ 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 ❑ II 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)
City,State ZIP Code County 10-05 -S7 OSO G03 060. 017
Primary property owner contact name E-mail
Under penalties of perjury,1 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
being filed.)
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Signa1tu�re fBuyerl Signature ofBuyer2/Spouse
4111 �4Nt c Fah S 4-n-13
Number License/ID/Other Number ry\
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