Homestead_Stout (2) INDIANA SALES DISCLOSURE FORM SDF ID: Pafle 2
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CHRISTINA LATHAM TITLE CLERK
Preparcr of the Safer&sale:sure Form hale
4703 THEATER DRIVE REGIONAL LAND TITLE
Acid ress(Number cad Szrees) Company
EVANSVILLE.IN 47715 812-402-4.553 CHRISTINAOREGIONAL-LTCOM
Chy,S=z end VP Code Telephone Number E-mail
VELISEllEta(Slattr' alartrentrt.atantVigX-11:3MINIMagkarigatUarAfignalgailaWelialinetflargiiat
Kevin O j_eiliits
Seller 1-Name as aPPeers on aonveYarcer jit Seller 2-Name as cpprs an conveyarreclocument
• oThesc., iinr, :t- Or
Address(NF.m.,:er and kree-t) Address(NYmber cnd Sate)
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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
and comp! te as rqq9Øed by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signemre of Seller 1 Sig natrre of Seller
Kevin D....Jeffries _X-3 427/20 /5 ,
Printed Name a"Seer Sian Date DOOLD/ITYY) Printed Name or Seller i_. i ! i 1 ' -MIL(Y-LfiDDifirt.
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Michael Stout Mamie L. StOtri
Beyer I-Name as appears on conveyance documr:: Rover 2-Name as appears on cc a v9=ce A PRen8 2015
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THE SALES DLOSURE FOAM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
ITS 0 CONDITION 0 CONDITION ......,
I 0 1.Will this property be the buyer's primary 1 .. 0 3.Homestead
residence? Provide complete address of prim. 2 /1" •.... ' -ru r eating/Cooling System
residence,including county:
0 2 5.Wind Power Devic
- e
Address(Npn.-1.-er and SL-ee:) 0 El 6.Hydroelectric Power Device
' 0 2 7.Geothermal Eneru Heating/Cooling Device
Dry,Maze ZIP coat County
8.Is this property a residential rental property?
0 2.Does the buyer have a homestead in Indiana to be Fl
vacated for this residence? If yes,provide D 2 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 S.7eet) acio-II-3er-cpoo -co/.goy-0 ol 7
Micitae:Stout
Crly..k.:re L?Code County -—
PrLmar y proper.y owner con=name E-mail
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