Homestead_Hutchinson INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINA(EREGIONAL-LT.COM
City,Stare,and ZIP Code Telephone Number E-mail
E:SELLER(S)/GRANTOR(S) ' : -_ - `-• _
SHERRI PICHON
Seller I-Name as appears on conveyance document Seller?-Name as appears on conveyance document
y Iaoo Li. W0r+tvt SI-. 'A*P+. r- 1
/ Address(Number and Street) A� Address(Number and Street)
XOakland CA-
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 c lete as r u d 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
SHERRI PICHON D$-09- 20L3
Printed Name of Seller I Sian Date(M.M/DD/rvtt1 Printed Name of Seller Sian Date(MM/OD/Yril)
.F.-BUYER GBANTFE S _._APPLICATION FOR PROPERTY TAX DEDUCTIONS-'IDENTIFY ALL ITEMS THAT'APPLY _. _ •_ ' T. .,_71
FFER a
• HUTCHINSON
Buyer l-Name as appears on conveyance d. eat / Buyer 2-Name as appears on conveyance document
Address(Number an• -)— / Address(Number and Street)
X / 2/35 /Ii(Ko,e/ G,/
•
Telephone Number E-mail
THE SAL DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONSFOR THIS PROPERTY.,IDENTIFY ALL OF THOS TAPPLY.
YES NO CONDITION I YES NO CONDITION
35 ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary nergy Heating/Cooling System
residence,including county: ❑ S.Wind Power Device
74 (D N 3 t) s ❑ 12 6.Hydroelectric Power Device
Address(Number and Street) n
Oft 1- A ND CAT y, J'N Gi r6SON ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP.ode County
❑ C.� ❑ 0 B.Is this property a residential rental property?
L 2.Does the buyer have a homestead in Indiana to be ❑ 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
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) 1Qr _l3 3-3W c O.M10�/�Ir
JEFFERY M HUTCHINSON h o t.(/• t.W (�`�
City,State ZIP Code County E-mail
�'• Primary property owner contact name -
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 gfi /0 ,
Ai
- 5gri.f ayerl Signature of Buyer?/Spouse
Number License/1D/Other Number