Homestead_Perkins (4) 1.11 •
INDIANA SALES DISCLOSURE FORM SDF ID Pa e 2•D.PREPARER' . - .. It. :a ` �-'f? ,-�,F :2-' '" ..+�-ti
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
782QEagle Crest Blvd Ste 201 Regional Title Services,LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
Ory,Scam and ZIP Code Telephone Number E-mall
•
E.SELLERS)/GRANTOR(S)'.. .. I - ?-}it .?' -.-; seFy 'oP%rt= =.:.?4.._::- <(>?ix;,i •...
Anthony Jacnh CnvAes Michelle Lynn Cowles
i Seller I-Name os appears on conveyance document Seller 2-Name as appears on conveyance document
• 1130 Cedar Si SW 1130 Cedar St SW
Address(Number and Street) Address(Number and Street)
DeWitt:: IN 46110 DeMotte IN 46110
'
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
• and commplete as required b law,and is prepared in accordance 'th IC 6.1.1-5.5,"Real Property Sales Disclosure Act".
i r//I� /'/7eev4� � �{tt.C.l/�n�, (q_9�L[T IJC�Y
/ ( r
Signature of ells er Signamr of Seller
I Anthony Jacob Cowles 02/2.2404 is. e-I - ter -e .t- al S
11('e.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT P�•la"b
YES NO CONDITION YES NO CONDITION GIBSON COUNTY AUDITOR
0 ❑ 1.Will this property be the buyer's primary 21 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 12 4.Solar Energy Heating/Cooling System
residence,including county: ❑ O
5.Wind Power Device
494 E Old Petersburg Rd.
Address(Number and Street) ❑ 12 6.Hydroetedt'ic2o er Device -
Princeton, IN 47670 Gibson ❑ Q 7.Geothermal Energy Heanng]`Leoling Device
Clry.State ZIP Code County
151 ❑ 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 ❑ 151 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.
1911 Bell Rd. Not available in all counties)
Address(Number and Street) /�t(� tt�/�
• Chandler, IN 47610 Warrick 9`(/r'05-3 1 saw-ow. Oa?
Clry,State ZIP Code County
Primary property owner contact name E-mail