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Homestead_Garcia
INDIANA SALES DISCLOSURE FORM SDF ID SDO ID 1802769 Page 2 Peggy A.Ralston Title Assistant Prepare,of the Sales Disclosure Form Tide 3101 N.Green River Road Suite 130 Columbia Title,Inc. Address(Number and Street) Company Evansville,IN 47715- 812-471-8563 pralston©columbiatitlegroup.com Cary,State,and ZIP Code Telephone Number E-mail Paul Hyatt Naomi I.Hyatt Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 417 S.Main 417 S.Main Address(Number and Street) Address(Number and Street) Owensville,IN 47665- Owensville,IN 47665- Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and mplete as required by law,and is prepared in accordance wi C 6-1.1-5.5,"Real Property Sales Disclosure Act". I �` • �. n ai of r S.nature of Seller (2"3- I L.,: It - . sat ... . I -',inert'inner! -•-• Cim,nrrr (PTTYW, •NTEE(S)-APPLICATIONFOR'PROPERTY TAX DEDUCTIONS-!IDENTIFY A ITEMS.THATAPPLY"-J1-1 :V .-"-:� • -Name as appears on conveyance document Buyerl-Name us appears on conveyance document 4515 Koester Address(Number and Street) Address(Number and Street) Wadesville,IN 47638- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO: +- . . • a .LL OF THOSE THADEIgY.3 YES NO CONDITION - ES NO CONDITION M," © ❑ 1.Will this property be the buyer's prima © ❑ 3.Homestead ' gHftlr{ residence? Provide complete address of• lmiry ,. . , •. I ' r�Dt,I' pITOR residence,including county: \ r�RSO W 8964 SOUTH STATE ROAD 165 ❑ © 5.Wind Poi Address(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Poseyville,IN 47633 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device Clry,State ZIP Code County ❑ .fl 2.Does the buyer have a homestead in Indiana to he ❑ © 8 Is this property a residential rental property? vacated for this residence? If yes,provide ❑ ❑ 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 Sweet) / Cy.Sate ZIP fade Cnunry -/Q dO•gad• 6ae a��•D / Primary property owner contact name E-mail