HomeMy WebLinkAboutHomestead_Treadway INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
CHRISTINA LATHAM TITLE CLERK
Preparer 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 Code Telephone Number E-mail
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James R Amick Karen D Amick
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
X 4-,75? u. 900 ---Cr 3 arae,
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Address(Number and Street) Address(Number and Street)
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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".
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,>Lc',uamreofSeller / Signature of Seller
James R Amick , / OTC//jr/ •Dis Karen D Amick %y/I`//Z°LS
Printed Name olSeller , ' Sian ate( I/OD/YYYY) Printed Name of Seller Sian Date LN.M/DO/YYY*
,F.;BUYER(S)/GRANTEE(S)_APPLICATION FOR PROPERTY AN DEDUCTIONS=.IDENTIFY ALL ITEMS THAT APPLY._.
Thomas Treadway
But' 1- tame as ap• ono. •eyaanncce ddo•:cu ent /'/t/ l/ . Buyer2-Name os appears on conveyance document
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Aa s Nu ber and Street ! Address(Number and Street) s
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION �—
n 1.Will this property be the buyer's primary Er 111 3.HomesteacGIBSON COUNTY AUDITOR
residence? Provide complete address of primary n Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑ Wind El
491 W 350 W S.VI nd Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton. IN 47670 Gibson n Q 7.Geothermal Energy Heating/Cooling Device -
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be El 8.Is this property a residential rental property?
vacated for this residence? If yes,provide n Q 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) /1�n O- w , (gca I
City,State ZIP Code County V -11- 3�0 -aoo- Y��L/\ [�-
Primary property owner contact name E-mail