Homestead_Welborn INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER_ - - -
Stacey Salzman Closer
Preparer of the Sales Disclosure Form Title
4962 Lincoln Ave. First Advantage Title
Address(Number and Street) Company
Evansville, IN 47630 812-490-8485 theteamno firstadvantagetitle.com
City,Stare,and ZIP Code Telephone Number E-mail
T _
E.SEILER(S)/GRANTOR(,_ ' _
Chad E Soeicher nee Cep Snpirher
Set -le as appears on cronce dacut_ne_ntt Seller 2-Name as appears on conveyance document
f Ol( camp
stRress(Nurm,berand Street) Address(Number and Street)
U0,-K_j a nd G t m 41(40
Telephone Number E-mail
Under penalties of perju%, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
`and pl toe as quire& by la v,and is prepared in accordance vC . . 1-'N'eal P .erty Sales Disclosure Act".
Signature o/Seller Signature of Seller
Chad F Speicher 0 8130/2 01 3 Dee Cee Soeicher 08/30/2013
Printed Name of Seller Sian Date(H.N/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
,F..BUYER(S)/GRANTEE(,'„APPLICATIONTOR PROP ERTY.TAXDEDUCTIONS±'IDENTIFY AL[i 1TEMSTHAT APRLY
Jodi L Welborn
(/erl mepsu rs on �1Nn'cedau,I1enr (((/yyy\'(�\/ Buyer g-N'ameasappears on cony nce daeu„ent �• �
All srumber and5treet) l� ( .-• . ia Address(Number and Street) {� '�
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TII
TY A� pITO
YES NO CONDITION I YEESS///. NO CONDITION C,i8S0hi GOO N
❑ 1.Will this property be the buyer's primary • 3.homestead
residen Provide complete address o rtmary ❑ gm 4.Solar ;FE g I --SSS 'stem
gres(denc i u icoun �\ ❑ ('
�� -Y'� u 5.Wind J.
A /��ss�(�upmbe�r at o-eey �y�� c1 t \mtr1 J❑ tr. 6. Hydroe r evlce
l l,.J�^ �� I 113 �I�J 1 ❑ .S 7. Geothermal epg l•Vv(3/Cooling Device
City,State ZI ode County
❑ 2.Does the buyer have a homestead in Indiana to be
❑ to 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ '∎ 9.Would you li to rec 'v atements for this
complete address of residence being vacated, property via contact information
including county: be/mCailifiThlegfZUNDIAPIAPPe information.
Not available in all counties.)
Address(Number and Street)
2 2_o Y/ 300 cc / 759 00 !
City,State ZIP Code County
Primary property owner contact name E-mail
Plumber License/ID/Other Number
•