Homestead_Sablone INDIANA SALES DISCLOSURE FORM SDF ID: Loft 013 Page 2
. D.PREPARER
Lynette Murray Processor
Preparer of the Sales Disclosure Form Title
4962 Lincoln Ave First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 _ 812-490-8485 theteam(ahfirstadvantagetitle.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTORS] . - - -_ - ._
Nathaniel 1 Brines Melinda J Brines
Seller I-Name asAmeamlin conveyance doc�u nt Seller 2-Name as appears on conveyance document
( /f321) v trarn w
Sanut-
rapt;J(Nurober an Street)
Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comp •teas required by la and is prepared in accordance wit. IC 6.1.1-5.5 "Re r Sales Di closure Act".
-a a - / i i
"gnature of Seller A. ature of Seller G� c,_
Nathaniel J Brines `(/ G U'Z°/I Melinda J Brines / r /J
Pn'nted Name of Seller Sian Da tE(MM/a /YYYY) Printed Name o(Seller ����""""'''''''' a a/Y7Y1)
F.BUY GFtANTEE(S)--APPLICATION FOR PROPERTY.TAX DEDUCTIONS-IDENTIFYALCITEM AJA PLY
Roger F Sablone ) gg r
auytrt Names .,yyt son Conveyance ocument Buyer 2-Name as appears on conveyance document 2 15
Io� t� Male 5 . OCT 16
dress(Number and Street) Address(Number and Street)
rincribM (Al /7Ip10 /b _
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 man ,r,na�r,na `
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
1208 North Main Street
Address(Number and Street) C_e I ❑ 0 6.Hydroelectric Power Device
Princeton, IN 47670 C �,,
I 1 UWJ ❑ 0 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 0 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 ❑ 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.
Address(Number and Street)
City,State ZIP Code County A4-42 -06 - 10 4/-000. Q.S .O X$
'mug property owner contact name •il
•