Homestead_Martoglio INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Angie Pace Title Assistant
Preparer of the Sales Disclosure Form Title
1911 Lincoln Avenue Clear Title Company
Address(Number and Street) Company
Evansville. IN 47714 812-423-8854
City,State,and ZIP Code Telephone Number E-mail•_E?SEL6ER(SJ/GRANTOR(S)'_ . _ •6:.-1- ._ - ___L __- - - -._ _- - _ L__ - __•
Sieve D Mallory Teresa K Mallory
Seller l-Name as appears on conveyance document Seller 2-Name as appea on conveyance document
/02 s. ,r,5 sue_ 5/2 f Ne:tit,,•cKJ `S+
Address(Number and Street) Add (Number and Street)
fr A"Uc/se
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 6-1.1-5.5,"Real Property Sales Disclosure Act".
1 l al
—Signature of Seller / Signature of Seller
7'et/e -b . _ 7- -/`/ 1ereSc_ K lAla/�orc7 (l'-G -/,
Printed Name of Seller Sian Date D01/00/1117) Printed Name of Seller / Sign Date(MM/OD/YYYY)
.F.BUYER(S)%GRAN TEE(SI APPLICATION:F.OR.PROPERT,YTAX7DEDUCTIONS IDENTIFYALCITEMS'THAT.APPLY_- - T' '
Bryan L. Martoglio
Buyer]-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1
697 N.275 W
Address(Number and Street) Address(Number and Street) , l
Princeton, IN 47670 t t
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALLQIF THOS T APPLY. `U//t
YES NO CONDITION YES NO CONDITION ii 004
ig ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead CoUNh,
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/CociltWystem
residence,including county: p
697 N 775 W 5.Wind Power Device R
❑
Address(Number and Street) ❑ 5 6.Hydroelectric Power Device
PRincelon. I■147670 Gibson El 5 7.Geothermal Energy Heating/Cooling Device
Ciry,State ZIP Code County
5
Et ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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.
ki3 S,e / Not available in all counties.)
Address(Number and Street)
;•,,,s4 .i,.. L4/ -7 7s ui 1_,tn,s5 Z 40- II -oa— 4 0 Ct oil c 7
City.Stare ZIPCade County
Primary property owner contact name E-mail