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Homestead_Johnson (6) INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
D-PREPARER. ; _ ••-,' y'r?x +.r, -- W4 _v:_/Mis er :mac.' -?�t .tit_ ; _ .
Becky King Closing Processor
' Freparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services. LLC
Address(Number and Street) Company
Evansville,IN 47715 812-759-5555
City,State.and ZIP Code Telephone Number E-mail
E,SELLER(S)/GRANTOR(S) ;: 4- =eey. ;; t4 -><,.t.-, s" ;:t R..- '_- - 1.-"P ara4l.w
• Ricky G Cates Sandi K Cates
Seller 1-Nome as appears on conveyance document Seller 2-Name as appears on conveyance document
6570 W North St 6520 W North St
Address(Number and Street) Address(Number and Street)
Owensville IN 47685 Owensville IN 47665
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a d co plete as r quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
A ? ; //
Signature of Seller Signature of Seller
Ricky G Cates 071)S/201 S Sandi K Cates 0// /S I 2.0 I C
Printed Name of Seller Sign Date(MM/DDfn•Yf Printed Name(Seller Slgn DareJMN o
F.BUYER(S)/GRANTEE(S) -APPLICATION•FORPROPERTY.TAX•DEDUGPIONS;l1DENTIFYACIr1TEMS:THA-TAP.PLi '~a =��"'"
Tracy K Johnson LaDonna A Johnson
Buyer I-Name as appears an conveyance document Buyer 7-Name as appears on conveyance document
PO Box 98 PO Box 98
Address(Number and Street) Address(Number and Street)
Posevville.IN 47633 Posevville IN 47633
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY G 9 2015
YES YES NO CONDITION Y NO CONDITION ey
0 ❑ 1.Will this property be the buyer's primary IN ❑ 3.Homestead /1 • _4 /
residence? Provide complete address of primary ❑ Fl 4.Solar Energy li to•Fr?
j residence,including county: ❑ Q UIBS�� _�• - • jDITOR
6520 W Wirth St 5.Wind Power Device
Address(Number and Street) p Fl 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ jl 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 17 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.
56 S Sham St. Not available in all counties.)
Address(Number and Street)
Poseyville,IN 47633 Posey �G– •^I _ 1/C ) 000- `?a 4-Qaa.
City,State ZIP Code County
Primary property owner contact name E•mall
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