Homestead_White (5)INDIANA SALES DISCLOSURE FORM SDF ID:
Paae 2�
LANA C. HARPER CLOSER
Preparerafthe Sales Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES, LLC
Address (Numberand Street) Company
EVANSVILLE, IN 47708
City, State, and ZIP Code Telephone Number E -mail
E.SELLER S' GRANTOR 5 :i £` r is . rt
ESTATF OF JERRY WRIGHT
Seller I - Name as appears on conveyance document
Seller Z - Nome as appears on conveyance document
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Addr (Number and Street)
Add. (Number and Street)
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City,
Tele hone Number E -mail
Telephone Number E -mail
Under penalties of perjury, 1 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 ".
Signamreo Ifer SignatureofSeller
P' eo Sian Date MM /DD Printed A'ameo Seller Sion Dare sew /DD
.BUYERS `.GRANTEE -'.- APPLICATION FOR PROPERn TAX ,DEDUCTIONS-
,IDENTIFY"ALL:ITEMS THAT'APPLY` --
LARRY A. WHITE
'nveyam, of ument
Boyer 2- Name as appears on conveyance document
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Address (Number and Street)
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State,
E -mail
Tele ho E -mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS F TY. IDENTIFY AL THAT API LY.
Y NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyer's prima
[ ❑ 3. Homestead
residence? Provide complete address o prim
4. Solar Ener g /Cooling System
residence, includinglcounty:
t lJ O
❑ 5. Wind Power Device
❑ Ey 6. Hydroelectric Power Device
A d ess(Numbe and Stmt)
/�/ % - 7/ b5W
❑ [J 11�7. Geothermal Energy Heating /Cooling Device
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❑ lla Is this property a residential rental property?
CiRt Sww PCode County
❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
❑ • Would you like to receive tax statements for this
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.)
/s/N�S'/_
4V _O�O• ^ ^ a /
Address and Street)
CiN, State ZlP Code Counry
Primary property owner contact name Email
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
being
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5(gnamreafRoyerl Signamrz ofBuyer2/Spouse
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Printed Legal Na .eaf Buyer I Sign Date (MM/DDIMI J Printed Legal Name of Buyer 2 1Spouse Sign Date (MM/DD/)Yn1
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Last Sdigits of Buyer l Driver's State Last 5 Digits ofsocia/Security Number Last 5 digits OfBuyer2 /Spouse Driver's State Last 5 Digits of SocialSecunty
License /ID /Other Number Number License /ID /Other Number