Homestead_Lewis (10) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
CHRISTINA LATHAM TITLE CLERK
Prepar er of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE. IN 47715 812-402-4553 CHRISTINA(a)REGIONAL-LT.COM
City,State,and ZIP lode Telephone Number E-mail
E.SELLER(s)/GRANTOR(S1 `. . _ . . . - - _- f - .A -9. , .. :•
' Pan!France
Seller I-"-me as appears on con pane document Seller?-Name as appears on conveyance document
. — 0 ! it /'! CE
Address(Number and Sweet) Address(Number and Street)
X7417.S ( co: u_-.
Ciy,State and ZIP Code I City,Statt and ZIP Code
rr) c.(/t° /IV.Slam/ // E- t it c,U/G_S
Teleohone Number E-mail Telephone Number E-mail
_
Larry G.Lewis
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
X 10K A c1 na*pu>A'4 sr-
Address(Number and Street) Address(Number and Street)
P,.S te ar �
YES NO CONDITION YES CO CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead _ -
residence? Provide complete address of primary ❑ Q 4
residence,including county: '
.
_908 Broadway St S.Wind Power Device
Address(Number and Sweet) ❑ 0 6. Hydroelectric Power Device
Princeton. IN 47670 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 11] 2.Does the buyer have a homestead in Indiana to be ❑ 8 Is this property a residential rental property?SI
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.) yn
Address(Number and Sweet) �)Co-r 12-OR - /0 1 -00 l t 1 31- oap
City.State ZIP Code County �t--XX w ✓✓
Primary property owner contact name E-mail