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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
IXPREPARERi. _:- ».: _a_- y.; __-,3 _— _.__ _
Cesar Berrios Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd,Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number E-mail
.:ErrSELLER(S)/GRANTOR[SJ' _ ---�-_._._—� �._ '�'.�_-�' __-� ,_ -_<._`.
I any R Hoover I i7aheth D Hoover
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
715 Kennedy Dr 715 Kennedy Dr
Address(Number and Street) Address(Number and Street)
Ft Branch IN 47648 Ft Branch IN 47648
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and cam lete as requir•d by law,and is prepared in accordance with IC 6-1.1-5. Real roperty Sales Disclosure Act".
i
Si, y eller ig azure of Seller
F.-
I any R Hoover C -Ia� 3 ,/O) 1 Li�abeihD Hoover -74-/ k
Printed Name of Seller _ Sign Date ptM/DD/YYYYj Printed Name of Seller Sign Date(MM/DD/YYYY)
,F E.,• •(S)%GRA • (SM.,APPL;ICATION_FOR PROPERTX TAX�,DED.UGTIONS=IDENTIMALL`iITEMS:THAT APPLW
Heather A. Smith
toyer I-Name as a • on conveyance document Buyer 2-Name as appears on conveyance document
901 Ritters am. Ave
Address(Num•er and Street) Address(Number and Street)
Vincennes, IN 47591
Tel E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO' PERTY. IDENTIFY OF THAT APPLY.
YES NO CONDITION ( I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary .11%.,,„„.82 c Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy He t g o lin s
residence,including county: ❑ 0 5.Wind Power Device
715 Kennedy Dr
Address(Number and Street) ❑ 0 6.Hydroelectric Powerjejt 2013
Ft. Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/ ooling Device
City,State ZIP Code County
❑ 12 8.Is this property a re' .entaalr yr: ..erty? '
El 5 2.Does the buyer have a homestead in Indiana to be 1j , VrOk
vacated for this residence? If yes,provide ❑ 0 9. Would you ly!{gia0:,-v: � y .-gq Aog this
complete address of residence being vacated, property via I . • . e• o ,YfinfoY,Thation
including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
(710/i-/3- /0/-00/ ///- 0A6
City,Stare ZIP Code County
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
bem filed.)//
1( (Jel a c czt(r x f
Signature of Buyerl Signature of Buyers/Spouse
Heather A Smith
Number License/ID/Other Number