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INDIANA SALES DISCLOSURE FORA SDF ID: Page 2
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DEBBIE JACKSON TYPIST
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Preparer of the Sales Disclosure Form Title
530 FREDERICA STREET FOREMAN WATSON LAND TITLE
Address(Number and Street) Company
OWENSBORO,KY 42301 270-689-2424 DJACKSON(@EW-LT.COM
City,State,and ZIP Cede Telephone Number E-mail
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MICHAFI 0 I IPSCOMR RFBECCA P LIPSCOMB
Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
10066 ASY STRFFT 10066 FASY STRFFT •::
Address(Number and Street) Address(Number and Street)
OAK!AND CITY IN 47660 Di. IQ. • • 1 _ .
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct t: .
and complete as required by law,and is prepared in accordance with IC 6-1,1-5.5,"Real Property Sales Disclosure Act".
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Sign°pre of Seller 7,1:
MICHAEL G I IPSCOMR 11/15/7013 REBECCA• I • •
Printed Name alter Sign an re(Mbi/DO/I)III Printed Name of Seller imp' ; I Milk Sian Dote WM MO AM]
IFI'BUYEitS 'GRANTEE S EAPPLIGATIONIFORPROPERTY.:TAXDEDUCTIONSIDENT1j7•L I I• NIS:.
ANGELA R.COLCLASURE
Buyer 1-Name=appears on conveyance document Buyer 2-Name as appears en convey‘anceliocument
5136 S.WASHINGTON STREET NOV 2o 2013
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Address(Number and Street) Address(Number and Street)
OAKLAND CITY,IN 47660 IMilhilt
TIIE SALES DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION ..
0 0 T.Will this property be the buyer's primary 0 D 3.Homestead
residence? Provide complete address of primary 9 E 4.Solar Energy Heating/Cooling System "-
residence,including county: i.
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0 fil 5.Wind Power Device
5138 S WASHINGTON STRFFT
Address(Number and Scree) 9 0 6.Hydroelectric Power Device
OAKLAND CITY.IN 47660 GIBSON 0 tyi 7.Geothermal Energy Heating/Cooling Device z-
civ,StateZIPCode County
D 12 B.Is this property a residential rental property? 11:
9 0 2.Does the buyer have a homestead in Indiana to be i.:
. vacated for this residence? If yes,provide 9 E 9.Would you like to receive=statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
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including county: below.Please see instructions for more information. 1.•:.
Not available in all counties.)
Address(Number and Street) .
tp _. ac3_ 02 40 ) aJC3 Z 0-Z 003 ---
City,State ZlPCode County
Primary property owner contort name E-mail
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