HomeMy WebLinkAboutHomestead_Douglas INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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LANA C.HARPER CLOSER
Preporer of the Soles Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES,LLC
Address(Number and Street) Company
EVANSVILLE, IN 47708 812-468-8485
City,State,and ZIP Code Telephone Number E-mail
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Seller 1'Name as apoears pn conveyagce document Rd Seller 2-Nome as appears on conveyance document
r7e) ifitier 7nitkr
Addr ess(Number and Screen)
O fiti g 765.- Address(Number and Street.)
Oil 17501/lc /
Telephone Number 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 mind,—• b law,an s is pr- I ared in accord.nce with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Sin atre of Salr Signature of Seller
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Printed Mame of Seller Sign Date r A01/DIWYYM Printed Name of Seller Sign Date(w4/00/YMI
W51311YERISIZGRANTEE(S)gAPPAOATIONIEORIWOHERTYJAXWEDUGTIONS-.1i1DENTIE.YeWITEMSkTHATiAPPLY.7-7 T.:77—7:::
SYLVIA BETH DOUGLAS
Buyer I'Name aoppearsi unveyangncua Buyer 2-Name as appears on conveyance document
AVaess(Number and Sun) Address(Number and Street)
lUlan_SORe, /AI 4/7666-
Telephone Number 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 YES NO CONDITION
Ur J 1.Will this property be the buyer's primary 5 ri 3.Homestead
residence? Provide complete address of primary 9 IS 4.Solar Energy HeatingEbig ystE D
% rsidence.insleingaty:
1103 IDsle_ir Ix r 9 5 5.Wind Power Device
artigitTfittscro im ow05..
G thsaa 9 5 6.Hydroelectric Power Device
9 51 7.Geothermal Energy HeathaltaikSiligngce
City,State ZIP Code Counry,
0 8.1s this property a residential rental property?
9 SI 2.Does the buyer have a homestead in Indiana to be 51
vacated for this residence? If yes, provide [1] 5 9.Would you like to receive,. t. -g.--el or this
t. ,, "t1PWrit.
complete address of residence being vacated, property via e-mail?(Pro - •- I- ,4- 0 Jazz&
4
including county: below.Please see iThIRI-29A P • •i .r II lainon.
Not available in all counties.)
Address(Number and Street)
2 tc, -/5- ok. 303 o oo 3 Kr) 027
City.State ZIP Code County
Primary property owner contact name Email