Homestead_Smith (2) INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2
• D.PREPARER
Stacey Salzman Closer
Preparer of the Sales Disclosure Form Title
4962 Lincoln Ave. First Advantage Title
Address(Number and Street) Company
Evansville.IN 47715 812-490-8485 theteam@firstadvantaaetitle.com
City State.and ZIP Code Telephone Number Email
E.SELLERS)/GRANTOR(SI . .-
Inn'F Lam= Debra I I ee
Seller I f-'Name as appears on conveyance document Seiler 2-Name as appears on conveyance document
399, COQeny` 1-r L5 C.-2L E Ae R same
Address(Number and Street) IY Address(Number and Street)
NO
Under pen (ties of erjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co p teas equire by�prepared in accordance with IC 6.1.1 ,5,"Real Propel'��Sales Disclosure Act".
/C_
Signal re af5dler( Signature
Joe F Lee /3/do/S Debra I I no ,5-L„3/2.0/-5
I. Printed Name o(Seller -Sidi Dot iMM/DDA•rYI Printed Name ofSeller -Sian Date(wejantelYn)
F.BUYER wS GRANTEE S -APPLICATION FOR PROPERTY TAX DE UGTIONS-:IDENTIFY ALL ITEMS TIIAT APPLY
[lalltI-- • Ell JIM�� R.lktt-
-
Rae ameorappearsncop ace document Bu do
-Name or appeors on conveyance document
. � s1 Le_ --4-- 1
d- s(Number and St rt t) Address(Number and Street)
THE SALES DISCLOSURE FORM.MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF E AT PPLY.
YES, CONDITION I YES , NO CONDITION
❑ 1.Will this property be the buyer's primary ® ❑ 3.Homestead ��pp��yy ,,{{ 99 ''rr,�
residence? Provide complete address of primary ❑ ❑ji 4.Solar Energy llMPIXg�Cdbllb%1System
rffCCt eppce''-i eluding.our ❑
""] I3_I� wire , `\ S.Wind Power Dedce
�(Nu-meaa «q =�� .�'^ • ❑ 0 6.Hydroelectric J�
ccy,smtezrPCad: `J
-
IlV canon ' N❑ El 7-GeotheMEITIdigglee 1Ti1edgMiggrice
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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) p
City,Stott ZIP Code County � L- R-31- 3Di Coo Pei Oo9
Ci
Priimmary property owner con:oct name E-mail