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Homestead_Staples INDIANA SALES DISCLOSURE FORM SDF ID: =...:,1•-.,r%%�.; Pape 2 LaD I.ITWARERt frsti /i ;t.i f -s.E1fS raT,- gZ>iri i. MLMiT M 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 theteamefirstadvantaaetitle.com City,State,and ZIP Code Telephone Number E-mail aE$SE ERrS 'GItANT,1)R S `F'�"'-=-•t t A s" -a'ss° A \ �TT_-_� � ����'::.+C..•ei .`'.lets[a•.'Pt�..1'.5?u.4n'.�-4c�"cS.-�"-�C m`0."�`••:r` � �r-Yi:'i-.: a-••- e.:s��.�.<i y`J.. y xac5 .�u :' v 7Tcla3twsi+ 7 q: lll/1 it hfc e 0 ~.�JI 02 ry QM C` hP //f r zmn/ ) Seller.1 N arapportion cony �'u conveyance document. Sel1e ame asa non cony ^h ry „ i c r r� / \J-k D conveyance document `�p� Number an Street) I `� v`J` � IC- I\) fjLu L2, �q\J (-1L-1 0 Address(Number and Street) 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". 1 wt / ci 7: +.-,> � - X_Af• La. tu_a Signature ofSel r " t Signature of Seller �,M irh (to 0 -4 . ti 1,-,n. ,I � 4 L4 '1 ( it' J(P L . �ro � e o n r.! L 4 (D 1/5 Printed Name of Seiler Sign Date Printed Name ofSeller San Date(MX/Do lei rAEIiS).% I:17J-In 4-11 $OJ2 art.PITIN'>(xaIlEn'WD CIITIIF 'laf EM� Btty2r� Name as appears on conveyance document Ad ess(Numf�nd'..` ) Add�(Number and Street) its r I- `12,t-o_rCk 1 ! I II bq 6 - -b CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. CC l 3 YES/ NO CONDITION YES' _ NO cONDrnoN C/RS �O/�' u ❑ 1.Will this property be the buyer's primary [� ❑ 3.Homestead U�'1�. residence? Provide complete address of primary ng i C1 residence,ingJ✓udin ou�y: ❑ © 4.Solar Energy Heating/Cooling 1 I. I �- ❑ ig 5.Wind Power Device /10 A_reis(Number at�{bpe s 1/ C'/� lT 'J ❑ 0 6.Hydroelectric Power Device L1' 11; fi S 10 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ ❑ 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) City,State ZIP Code OZ -/9--09- ti 00 - 0W /13-COTS- [aunty Primary property owner contattname E-mail