Homestead_Deffendall (6) ""INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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D:;P:REPARER . > . . . -1717-- - -- � _, . 1 - ,11:_
LANA C. HARPER CLOSER
Preparer of the Sales 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
EiSELEER(S)%GRANTOR(S)Y- L : ' . r..`^7 11317"; - ;TS-
: -- � 71;.77- .::." ':-. ---_ Ty.--7 '. T-
RICHARD D GILMORE MELISSA S GII MORF
/W q Dunlap appears document Seller/S/ypmeasCtppears pconreyan[ [��men/[
14-100-to41 IN 47&7o t'ri�7Ja(e%"x"Street)
e/(/It/f JN / 76)76
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/rrequuiired by law,and is prepared in accordance with .-1.1-5.S,"Real Property Sales Disclosure Act".
ature of Seller Signam of Seller
Si rich E-A Q - CILmoRF L-9-151 /V S<<a. S. 6/more, '-9-/S1
Printed Name of Seller Sian Date(MM/oD/MT) Printed Name of Seller Sign Date(MM/oo/YYn1
•F..BUYER(S)/.GRANTEE(S)`_APPLICATION.:EMPROPERT;7 TAX,DEDUCTIONS=IDENTIFY'ALLITEMS:THATAPPLY - _ ____.
CASEY L.COEFFENDALL COURTNEY M. DEFFENDALL
Buverl-Name as appears o conveyance Darnel?! Bu 2-No a asa rs on eo eyance daeu t
/279 Dun�la.p r JA/Q w/a,p a-/ae,
Address(Number a dStreet) A (Number an Street)
Pr(nce love IN h17p70 117 aim //tl /7�7o
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 YES NO CONDITION
NI ❑ 1.Will this property be the buyer's primary El El 3.Homestea pgq
residence? Provide complete address of primary ❑ Q 4.Solar Energy He mg tg S em
resi nce inc ding county:
/3/9 D n G� ❑ 5.Wind Power Brice
1 5 2014
ess(Number ndStreet) ❑ gi 6.Hydroelectric rower evlce
r�i�e n //� �71oT0 �ihson ❑ 0 7.Geothermal E gy He 'n Device
City,State?P Code County
1 ❑ IN 8.Is this rope ental property?
2.Does the buyer have a homestead in Indiana to be ❑ .,yIB��N COUNTY t���E�IQ Its for this
vacated for this residence? If yes,provide 9.Wool ou I e t c I e
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.)
Address(Number and Street) ,6-OS- 33- loo -003. 9153-0a2
Cry,State Be Code County
Primary property owner contact name E-mail