HomeMy WebLinkAboutHomestead_KiernanINDIA\A SALES DISCLOSURE FOR�1 SDF ID � SDO m 470669 Page 2
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Caroline Schneider Closing Agent
P�epartra/�hrSalaD"orharreForm Titlr
975 Main SVeet. Sutie 600 Regional Title Services LLC
AOdreu(NUm6r' ond5vttt) Company
Evansville, IN 47708-
?E'SHL ER S TCF2ANTOIi S '��t���r.i�ii:�,``�.�.,��.:•.i�T'�-'�kz�.���,�'X�':r,�"�.`s�'."�°���;'�?3� �,"�y�;�c�`�"�;_: �,�
Channon Robb
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307 S. McCreary SVeet
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Ft. Branch, IN 4764&
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Under penal[ies of perjury, 1 hereby certify that [his Sales Disclosure, [o the 6es[ of my knowledge and belief, is We, correc[
a Eo' plAe[e as required b��n� prepared in accordance wi[h IC 6-11•5.5, "Real Proper[y Sales Disclosure Ac['.
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Agnamre ofShcer Lgnamrt oJ5e11er
Channon Rnfih 6/16/2010
YE ^ � � � TEE S �'AP,P.LIfAT10NEF,OR-�P,ROP.ERT-YaT C ONS=;IDENTIF.Yi � `�ITEMS:THAT�P�Ye�'�:+is3'��
PaVicJc A Kieman Pamela IGeman
Buyvi-Nan.ecscppevrson m�eyvn¢docvn.en[ . EvyerS-Nameatappefrron nmdcevmn�
Addre4(.\'um6erandSUeeQ Addref(Numberand5veet)
Marposa , CA 95338- Marposa, CA 95338-
Ciry, Smtq and Z1PCade Ci9: Smtq and ZIPCode
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TIIESALESU[SCLOSUREFORMMAYHEUSEDTOMPLYFORCERTAINOEDU ONSFORT{IISPROPE FYALLOFTNOSETIIATAPPL
YES NO COYDITION 1'FS NO CONOI770Y `
x❑ ❑ 1. Will [his property be [he buyer's primary �x � 3. Homestead
residence? Provide complete address of prima Q q, Solar Ener ' g/Cooling System
residence, including county:
5703 S 775 W 5. Wind Power Device
Addrm(Numbvand5tr¢[) � Q 6. Hydroelectric Power Device
Owensville, IN a7665 GiBSON � � 7, Geothermal Energy Hearing/Cooling Device
dty, Smtt ZIP Lode Counry
�� 2. Does the buyer have a homestead in Indiana to be � Q$• �s this property a residential rental property?
vacated for this residence? Ifyes, provide ❑ Q 9. Would you like to receive tax statements for this
complere address of residence being vacated, property via e-mail? (Provide contactinformadon
including county: below. Pleasesee inspvctlonsfor more informodon.
No[available in all coundes.)
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Clry, Smte ZIPCOde Covnry
Primaryproperry'ownrrcmmanome E-mafi
Under penalties of perjury, l hereby certify tha[ [his Sales Disdosure, to the best of my Imowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance with IC 6d1-5.5, "Real Property Sales Disdosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/Other num6ers are not necessary i(no Homes[ead Deduction is
being fil
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Patrick A Kiernan 1�it�5///% Pamela Kiernan /a -/�- /�
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