Homestead_Thompson (3) INDIANA SALES DISCLOSURE FORM SDF ID: __- Page 2
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EEPARER' .______,...St `M` --;s= s �°.3 ± _.._.____..,..a:MS22.7 a1 _ - __ -,`14747. _. . .�,...
R.Jeff Dodson Title Closing Agent
Preparer of the Sales Disclosure Form Tide
1911 Lincoln Avenue Clear Title Company
Address(Number and Street) Company
Evansville. IN 47714 812-423-8854 ctc@sigecom.net
City.State,and ZIP Code Telephone Number Email
-E:SEf:L'ER(S)/GRANTOR(S]._. - ., -11,12i117.'::,-7:—.2...,?-1.:._..,Y;-,,.-•...:... _ '.._..... _..2 a;l -- _ - . _..-- -. . IT ... ,_
Tracy J Krieg Kyta D Krieg
Seller I-Name as appears on cony once doe ent Seller2-Name as appears on conveyance docum .
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Ad�,ess(Number and Street) I 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
andseatiplete as required by w,and is prepared in accordance with 6-1.`5.5, "Real Property Sales Disclosure Act".
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Printed Nome •eller Sian MiffM/DD Prinu.d.Namco Salle;:311:11Rara.Mr Sian Date NM DO
W;'BUYER(S)7GRANTEE(S)? APPEIGATIONFOR,P,ROPERTlYTAX,DEDUCTIONS,_dDEN ' ,Y,At,''L-L 'MS=T' '' `PLY._ - - r
Andrew Thompson tlxh,y�b ]r pa��t��
Buyer 1-Name as appears on conveyance document Buyer 2-Name us appears o bh ya oa
504 E. Maple Street
Address(Number and Street) Address(Number and Street)
Francisco. IN 47649
TIIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR TIIIS PROPERTY. ID N FY AL OF TIIOSE THAT APPLY.
YES NO CONDITION S NO CONDITION
5 ❑ 1.Will this property be the buyer's primary 0 in 3.Homestead J
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
504E Maple Street 5.Wind Power Device
Address(Number and Street) ❑ 12 6. Hydroelectric Power Device
Francisco, IN 47649 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 5 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Er 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)
L3- do --/o3-000. ► sti-aas
City,State ZIP Code County
Primary property owner contact name E-mail