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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
• -D...PRLPAkER `{..•ti. ;ter ` ,-,?i- ._ .,__ ai 'r.;,.7am . .':- . a..... . ...r..: ", .4CfLz,e=- li'.
Don Dowell Manager
Prep.rer o/the Salts Disclosure Form Tlde
507 N Green River Road Direct Title Insurance Agency, Inc
Address(Number and Sane) Company
Evansville IN 47715 812-253-3090 ddowell(a)directtitleinc.com
Cr.)'.Star,end ZIP Code T elephcee Number E-mail
1E:S C-I:ER(S) GRANTOP(S).e. .r ...;,:a lfO.r.... .n ze,"_=_.ea (s :arXzt,- agi+„ !x"E-e'x'r.sa s hx -
S ai /e Site G . .. I V - . ,
Seller I-Nameas•-peon an cam . document -,teaor Seller 2•Name os appears an cor eyance document
.123 w. S'taf t +
ra(Number end Sant Addras(Number and Street)
Val ACch3Y'i ,--Li '{'lV-7 O
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my Inowledge and belief,is true,correct
and complete as re as 4 by 1 is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Sis;nene/ee of r Signature of Seller
L In - r . i 1 ..- . , ./ ,d e ,
Pr:n:ed Name cattier Sian Date(A04/DD Panted Name of Seiler Sian Dote(AM/Dr,nrni
;F:1?'DYER(S)f GRANTEE(S).,APPLICATIONFOREROpERTYTAr DEDUCTIONS—aIDENTIFYAisftlTENCSAIHAT=APP1115 ;:Pial
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ayl•erf � �p fiA
eon an conveyance document Flyer 2-Name ciappears on conveyance document
5.2a4 E sf) S
ess(Number and Street) Address(Number andSreeq
A'ne(sco 4(--74Le ct
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YErSIN 0 CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary f❑ 4.Solar Energy Heating/Cooling System
r Ida e,in ud' g county: ❑ ❑
Ithi& .a, E 5-Wind Power Device
A}drps(gal:.beraH eeoJn /F'�IM ❑ ❑ 6.Hydroelectric Power Device
(�IJ1p� L./ C� ❑ ❑ 7.Geothermal Energ-v Heating/Cooling Device
City,Sac.VP Code Canty
❑ '.Does the buyer have a homestead in Indiana to be ❑ ❑ 8 Fs 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 Saver)
4otoc Clan Srr ZIP Code County
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Primary property owner canton name Eraa