Homestead_Young (2) e
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARERS.:_...,._.- e.:. - s yi-sTt r--•:. ,F -f a'•, ....z an-•Z-rr -_ri wtT-'- -.-s 7a.:-.;t 17,-,�a
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 ctcesigecom.net
City.State,and ZIP Code Telephone Number E-mail
E.SELLER(SVCRi1IJTOR(Srs .. '.Yip—:, `T.:: t' " . 'i4'.. E`.Svf-fS n_..iX4tcs'il�?.',°_""..aa . 7)2:`_ ,`?'_ ...Ti
lnli A Hensley n/k/a Juli A Fllswnrth
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
@f;I\cP"4-nn, Li 0 (21/ (9
_
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and a mplete as re uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
1�: -L1�ku n �
S ture ofSeller Signature of Seller
1,I ' ✓1 . I Ls worth , alaoI--
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/00/YYr/)
'F.BUYER(SV GRANTEE(S]t;-.`,`APPLIEATION EOWPROP.ERTYrTAXWED.UCTIONS `IDENTIFY;ALUITEMS±THATAPPlic''? z,"_F:_
Blake Young
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
401 W Warrick Street
Address(Number and Street) Address(Number and Street
Owensville, IN 47665 ��� --
TIIE SI.FS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT AP LY.
YES NO CONDITION YES NO CONDITION
F4 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Hom%cf�ot4 COUNTY P•UCITOR
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ O
401 W Warrick St S.Wind Power Device
Address(Number and Street) ❑ Fl 6. Hydroelectric Power Device
Owensville, IN 47665 Gibson El 12
City,State ZIP Code County Geothermal Energy Heating/Cooling Device
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.1s this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 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) -/
City,State ZIP Code ? Id —/ 7/a -0703 oQc o 5 0cRQ
County
Primary property owner contact name E-mail