Homestead_Egbert Jr I
INDIANA SALES DISCLOSURE FORM SDF ID: I Page 2
1:D.PREPARER l a. . -., `: z - ,ae:-{. _`-:.7 .,:"r " , _''_ _.. ... -C '� .. - _'•
CHRISTINA LATHAM TITLE CLERK I
Preparer of the Sales Disclosure Form Title 1
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE. IN 47715 812-402-4553 CHRISTINA(E)REGIONAL-LT.COM
City,State,and ZIP Code Telephone Number I E-mail
.:E.SELCER(S)/GRANTOR(S)'=. .. 2.::-.Lt.-_ +. _ ,f-T '� ,. _ .. .; z .t _ _i -.ir.t; _.. _.. : I"
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DEAN A WILLIAMS KATHI FFN.1 WI! I IAMS RY DFAN Al I FN WII I IAMS ATTY IN FAC
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Adlci.p)• sc,c K-5-c„, St Cf H. k) ktcstltt S ti.
dress Nurnberand tree[) dress(Number and Street)
OA4YLi O ; f TN. 1-064,0 C.GK Ic) 6iic Lai Lingo
g enalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
plete sfe,�pl by law,and is prepared in accordance w IC 6-1. 5.5," al P erty Sales Di sure `� I � /
11q(.(/ cm 10 'f L3 i N Ut. M�N LA
Signature of Seller '� Ilpq, 1 /0- , '-13
DFAN A WI! I IAMS KATHLEEN J WILLIAMS BY DFAN ALLEN WI
Printed Name of Seller Sian Date(M.11/00/YYYY) Printed Name of Seller I Sian Date(M.N/DO/YYY11
:F.BUY ER(S)/GRANTEE(S)-APP LIGATION.FORPROPERTY-TAX DEDUCTIONS=IDENTIFY AbC:ITEMS+THAT-APPL72,.L . -,__ _
ROBERT B EGBERT J f • TRACY f%EGBERT'C I
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
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Address(Number and Street) / Address(Number and Street) I
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THE SALES SCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES—�0 CONDITION
❑ 1.Will this property be the buyer's primary I I 3.Homestead 1
residence? Provide complete address of primary ❑ 5 4.Solar Energy Heating/Cooling System
residence,including county: ❑ ip t
5.Wind Po, r 'I
Address(Number and Street) n 5 6. Hydroele ric l s e
❑ El 7.Geothermal Ener Ike tins cooling Device
Ciry,SmreZIP a County 'J.. gM1P T
❑ State
the buyer have a homestead in Indiana to be ❑ 8.Is this grope l 31 tbntal property.
vacated for this residence? If yes,provide n is 9.Would you like • receive tax .ta -••ents for this
complete address of residence being vacated, - property via e-ft ? :i •B:il(on tact information
including county: below.P/ g•Alps6Fy 'olnsgropltpOptnformation.
Not ava`}lla�t blle in air counties.)
Address(Number and Street) I
ROBERT B EGBERT ir, at2-I lf-ig-)oa-ocnSa -cn7
City.State ZIP Code County
Primary property owner contact name I E-mail