Homestead_Taylor (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINAeREGIONAL-LT.COM
City.State,and ZIP Code Telephone Number E-mail
Estate of Elizabeth M Keasling
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
'4f-CO r'T.,s'‘-x-ss-C
Address(Number and Street) s.--.1 "----) Address(Number and Street)
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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 bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller 0 i -44.at E_ Signature of Seller
Cristie A Harry Personal Representative (C.)._01 20 Its&
Printed Name of Seller Sian Date(31.4(Orynin Printed Name of Seller Sian Date(1434/DO/YYYY)
:F:BUYER(S)'/GRANTEE(Sy-APPLICATION.F0a.EROPERTY TAX DEDUCTIONS=IDENTIFY ALL ITEMS_THAT,APPLY:: r_
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Samantha K. Taylor .
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
C?c■IN C'e U 1% C Al 41:1 0°
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF TH 0 . HA APRLY.
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YES NO CONDITION 1 YES .'0 CONDITION
V i 1.Will this property be the buyer's primary 3. Homestead NOV -j, 2MA
residence? Provide complete address of primary 0 al 4.Solar Energy Heating/noCiirtystem
residence, including county:
ri p 5.Wind Power Dev. .
826 North Main Dr
Address(Number and Street) 0 NI 6.HydroelaggE
oUN COIMTV
Oakland City, IN 47660 Gibson 0 igi 7.Geothermal Energy vicatIng/NateRvice
City,State ZIP Code County
111 SI 8.1s this property a residential rental property?
0 El .Does the buyer have a homestead in Indiana to be
vacated for this residence? !ryes,provide 0 151 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)
-1,g '.- 1 OCR OW.59s-o)
City,State ZIP Code County
Primary property owner contact name E-mail