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Homestead_Shuttle
INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2 Peggy A.Ralston Title Assistant Preparer 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(ecolumbiatitlegroup.com City.State,and ZIP Code Telephone Number E-mail TE:SELLER(S)%GRANTOR(SjTC_,-,�__--__._ n t E_7.—'.-777-i. 7, ------ --7 __ --,— ----- _Rick Walden lerl N e sap rs on convey nee document Seller 2-Name as appears on conveyance document �g be 612ty fk . ress(N tuber and Street) Address(Number and Street) cU-o6z I!J LIIQ(Q(C Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and comp to a equirv,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Rick Walden 5/1/2015 - Printed Name o(Seller Sian Date NM/DO/MY) Printed Name of Seller Sian Date(M.4/DO/YYY?) .F:BUYER(S)`/GRANTEE(S)_APPLICATION FOR.PROPERTY TAX DEDOCTIONS IDENTIF?ALL'ITEMSiTHATAPPLY__� _T Justin E. Shuttle Courtney Shuttle Buyer;r Na as app ro document 'H 2- ' me as appears co eyance document l lLejslf(Number and Street) a (Numbe ands -er) A.-4-J.vnnep-bn., Inl Lt1((lo mUr� i THE SALES DISCLOSURE FORMTIAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION ,h IZI ❑ 1.Will this property be the buyer's primary (Z ❑ 3.Homestead /n4l'a residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Coolie: ystem 2O/s' residence,including county: ❑ • 4728 North County Road 200 Wet 5. Power Devic�'/QSO Address(Number and Street) ❑ 1Z 6.Hydroelectric Power Device COu .89))./ Patoka, IN 47666 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling City.Stare ZIP Code County / ❑ Q 2.Does the buyer have a homestead in Indiana to be u g 8.Is this property a residential rental property�OR vacated for this residence? If yes,provide ❑ Z 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) old-o5/ 4 - 000 G99- ©Y? City.State ZIP Code County Primary property owner contact name E-mail