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Homestead_Teeters
Pi INDIANA SALES DISCLOSURE FORM SDF ID: Paget 0.PREPARER . - = Stacey Salzman Closer Prepare,of the Sales Disclosure Cann Title 4962 Lincoln Ave. First Advantage Title Address(Number and Street) Company Evansville,IN 47715 812-490-8485 theteam(hfirstadvantagetitle.com City,Start and ZIP Code Telephone Number Email E.SELLER(S)/GRANTOR(S) ,._ _Teresa R Smith Seller I-Name as appears on conveyance document Seller?-Name as oppwn on conveyance document _2169 N V4)E Address(Number and Street) Address(Number and Street) Pri 'nn IN 47670 __ City.State and ZIPCode City,State,and ZIP Code Telephone Number E-mail Telephone Number E-mail 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-S.S,"Real Property Sales Disclosure Act". X Signature of Seller Signaure)Seller Iet?s&&Smith Printed Name of Seller Sian Date mumo/IlYll Printed Name of Seller Sian Date(MMIGn/YYYY) I RUYER(S)/GRANTEE(S .-APPLICATION.FOR PROCER'IY TAX i)EliU(TION IDENTIl7 [I .lTl k1S.TIIi1T;APPLY _ - _ - Cit ii (j. --FCi.s: -l(. : ti, .kjWe� Y , . —U :�l s�ih Buser I- : me as appears an tansefamr document Dupe 2-1 n appears on conveyance document 1. JO9z6, 9G•) //p7 X 2I6oC1 15 &VE Address(,NumberandStr et) Add L'maberandStreet)) _ 14 v\„ ,-+--- ( k 9 (z: 70/ I. ��_I-t1(-Q. k-G?\ --A--d y7:10'1J TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. Y Oin NO CONDITION YES NO CONDITION IY�-Y_ y '�14 2-014 w� ❑ 1.Will this property be the buyer's primary ±±1.--' ❑ 3.Iomestead LUiY residence? Provide complete address of primary ❑ is 4.Solar Energy t eatil t- ,.o i ',;,�. • / resl ence,ii cluding c nty: I Nt I4InA st, 7 gi a ” I ( _ / f_ 3 U [ [ S.Wind Pal e lU 1 �'9S ?1 ,�1tII D JVm®IApRITOR lttress(Number ofd Street) ("�,� (� ( l ❑ [Ii 6.Ilydi'oelec-nc over oevlce I ( n C-.4_-,-(; ! \:.iY—Y Ch r, 1�/ (��Nn'J❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code 1 Coon& TI V�Uoes the buyer have a homestead in Indiana to he ❑ 17) 8.Is this property a residential rental property? vacated for this residence? If yes,provide U CI 9.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.) Address(Number and Street) Ca,:Stare ZIP Code t:nand a-0 s-3 4-(200- D© i (4 _3 4-OR 1- . Prunury property owner contort name E-mail