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INDIANA SALES DISCLOSURE FORM' SDF ID: , Page 2
•D.PREPARER i , Yr: - a -' •- ,:.. - , t1. a, .
LANA C. HARPER _ CLOSER `
Preparer of the Sales Disclosure Form Tide 4
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES,LLC I
Address(Number and Street) Company
EVANSVILLE, IN 47708 812-468-8485
City,State.and ZIP Code Telephone Number I E-mail
+E:SECCEKS)'/GRANT OR(S]3"-*•=h'•^`•xre41144r-;11"Zrr„-nr."li,,,,�t» n:el'ti *trF;''C!".r^atlit4t it:gn51?� w.s_rn°1Ettrf.z .aln !f,-4a4"7 4iKr
JOHN J.JONES FAITH K CI ARK
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyancedocument
LS 3• 5hanneei I-eau sot J. church s+-!.
Address(Number and Street) Address(Number and Street)
kvansut/(i, /A) �72A5- 1- ,.44 To H71435
r
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".
Sig re ofSeller� U Signature of Seller
. ) 011sn ,J Js" -5 /, -/7-/3 Faith K. (" /arkl l01 il7/23
Minted Name of Seller Sian Date(MM/DD/YYYI) Printed Name of Seller I Sian Date(MM/UD/TYYI)
-F/BUYER(S)/GRANTEE(S)c:APPLICATIONFOR-PROPERTY-TAX DEDUCTIONS-'IDENTIFYALL ITEMS THAT APPLY. -
tIGATTICLAIM LAURA K.CLARK I
01—S..,ru upp.ars oh conveyance document Buyer 2-Na a as appmrs on conveyame document
9391 E. TON; FORD RD- ¢3 F - -Sohri FnYC1 IZcJ
Address(Number and Street) Address(Number and Street)
IIALLETON. IN '17010 Hnit+on
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE'THAT APPLY.
YES J/ NI- CONDITION I Yc SO r1INIZTION�
IL\^SAI , 1.Will this property be the buyer's primary (t n ❑ 3.Homes&
residence? Provide complete address of primary ❑ 0 4.Solar Energy I niC li tp
��/o / residence,including c<J ❑ 151 ���-���AAA���
4 `t E John f-"'D/4J )CQ( S.Wind Power Device
Address(Num rrandStreet) '/ /� �, I ❑ ID 6.Hydroelectric Pow 2v2E62013
- 17.Pl-fOI-- f / ` -7� l�(/�5�'" ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County I
2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a ri deeti.Jre s, i : -operty?
❑ Y I t,• Can n1.
vacated for this residence? If yes,provide ❑ 0 9.Would yot ® •r-• -0 a -ments for this
complete address of residence being vacated, property via e-mai . '-o9 I- LYofit�Rli1 Rhoden
including county: below.Please we instructions for more information.
Not ava' er '
Address(Number and Street)
.Z lv-05 - 57 -1117 -DDS. {QS - O/.7
City,State ZIP Cade Cou4
'Primarypmperry oumermn c -mail
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