Homestead_Villinesr
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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
LANA C. HARPER CLOSER
Preparer of the Sales Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES. LLC
Address(Number and Street) Company
EVANSVILLE, IN 47708 812-468-8485
City,State and ZIP Code Telephone Number E-mail .
IE..SELLER(S)/GRANTOR(S)"' 4_•.r'
JANICE WAI LACE
Sellerl-Name as°paw pn conveyvrc acumen Seller Name as appears on conveyance document
14/60 i_ Stair "Eel AkQi urib oulifStreet) //
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
l/.�in.t/r e YL.47eee gie3,
.- day1 of Seller ��O , / Signature of Seller
\Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller a>1 D/YYn)
F..BUYER(S)/GRANTEE(Sf .APPLICATION;FOR.PROPERTYYTAXDEDUCTIONS I
IDENTIFYALLTEM '' PLY _ljt _ L-
CIOUISE VILLINEST _
Buyer s-aarnrasappears on conveyance document Buyer 2-Name as appears on conveyance document
_,30711 Lu. OftK .¢v-e_ MAY 2 6 2015
Address(Number d Street) Address(Number and Street)
Lead All 4J- 7"2•4 01 ��
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES ig rnmlo
cr \
0 El 1.Will this property be the buyer's primary `* ' l ❑ 3.Homesteac
residence? Provide complete address of primary ❑ El 4.Solar Energy Heating/Cooling System
2i�c` -, residence, InS/ nty. ❑
{�' / c , !u -7t' / / S.Wind Power Device
f�//1 trY/ t/V y 74 7 �%//JSO/� ❑ 6.Hydroelectric Power Device
❑ 1g 7.Geothermal Energy Heating/Cooling Device
Ciry,State Zl Cade County
` 2.Does the buyer have a homestead in Indiana to be ❑ 0 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.
Address(Number and Street) p 2
City,State ZIP Cade county .2 -/c?_o -30/-003. OAt _O_R
--mary property owner contact name E-mail