Homestead_Mayberry INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER = . . P - – –1 _
Stacey Salzman Closer
Preparer of the Sales Disclosure Farm Title
4962 Lincoln Ave. First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 812-490-8485 th Iteam(Wfirstadvantagetitle.com
City,State.and ZIP Code Telephone Number I E-mail
E,SELLER S ,GRANTOR'S s - ;.a_c__— -
Patricia E Nurrenbem
Seller I-Name as a pears a cq onvo ep dorvment @v. c 5 Seller 2.Name as appears on conveyance document
a.11 0 Address/,ty(be and Str t) ^ Address(Number and Street)
Telephone Number I 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 6-1.1-53,"Real Property Sales Disclosure Act".
Chkga. es e lakA9-0S/Ai∎ f I
Signature of Seller Signature of Seller
Patricia E Nurrenbem 11/04/2013
Printed Name of Seller Sign Date Wm/DO/TM) Printed Name of Seller I Sian Date IMM/UD/YYY11
'F:BUYER(S)/GRANTEE(S)nAPPL1C ATITNE014ROPERTY;TAXDEDUCTIONS=.IDENTIF iALL';ITEMSTHATAPPLfa''_•
(Deborah L Sines
rs on am, I
eyaqr ocument Buyer 2-Name as appears on conveyance document
Address(Number nd Stmt rn' ��� Address(Number and Street)
Telephone Number I E-mail _
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION . . . ' I
ty ❑ 1.Will this property be the buyer's primary V • 3.Hmneste.
residence? Provide complete address of primary • �� •. o ar Energy3eat'g FiLgte�
'\ sid e,in udin go n I
—•1 � ff tl/� -A ty ❑ 5.Wind Power Deviic� ,/ q
l s(A'umbe .. trees) t'��m� /' I ❑ Si 6.HydroelectriCfrottf'Devit?013
f I - k `C �e�• ❑ 7. Geothermal Enerl Heatin•/Co Ili a !evice
City,S.••.ZIP Code County I �i' • I NI -
❑ A 2.Does the buyer have a homestead in Indiana to be ❑ 777��� """ 8 Is this property .Er.;.Y,.. +±n!� sal property?
vacated for this residence? If yes,provide ❑ u( 9.Would yoQI( �c 1i P1 I S gs for this
complete address of residence being vacated, /` property via email?(Provide contact information
below. Please see instructions for more information.
including county: 1 f f
Notavc. r. • • r ounties.)
Address(Number and Street)
City,State T.IPCOde Cou y A4 ' /9 _/67,/iii- ODD' o1 J'6-oa 6
• • er contact name I -mail