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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.D.PREPARER ,_ - - - - - . -
LANA C. HARPER CLOSER
Preparer of the Sales Disclosure Form Title
19 NW 4TH STREET STE 500 TOTAL TITLE SERVICES, LLC
Address(Number and Street) Company
EVANSVILLE,IN 47708 812-468-8485
Dry,State,and ZIP Code Telephone Number E-mail
E-.SELLER(S)/GRANTOR(S).. . . - 'BRAD I SNYDER
Seller I-N me as appea on convelan¢dace enI Seller 2-Nome as appears on conveyance document
10 , t'2
dress um}.rr ond5tree Address(Number and Street)
Luansu ' tie_ Th 471 9.r __
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an om lete as req led by I v,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
, an re of Seller Signature of Seller
5�Aa p t , _s' ve G e‘ 9 -�i-i
Printed Name of Seller Sion DatelMM/DU/YYYY) I Printed Name ofSeller Sign Date INM/DD/YYYY)
:F.BUYER(S)/GRANTEE(S)--APPLICATION-FOR PROPERTY TAX DEDUCTIONS-_IDENTIFY ALL ITEMS THAT APPLL _ _
JAMES E.JOHNSON BEVERLY M. JOHNSON
B at-yN�am as app on conveyance document' / / 1.
•^`
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. 4j'28 ,S
YES NO CONDITION I YES NO CONDITION ` f`
12 ❑ 1.Will this property be the buyer's primary 12 ❑ 3.Homestead C)eSONC
residence? Provide complete address of primary n 0 4.Solar Energy Heating/Cooling S},5ain,'
resid ce,including cou ••Ty
//o e`7. t ti 5//) ton , ❑ 5.Wind Power Device UO)r0
Add (Number and Street) `,J ❑ 12 6.Hydroelectric Power Device rr
tr/no fj/) __LA /7670 C l b A ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP..ode 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? !ryes,provide n Fl 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) / OD/.
City,State ZIPCode d -/! /a-tiad- ..57/6- Da7J2
County
Primary property owner contact name E-mail