Homestead_Wilkerson INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
i D. PREPARER - - '
Prepares of the Sales Disclosure Farm
r, i`- / lei Title /I�1S / /t
/:-y�•1� !l 1 T \cult-Lrl� vlY ; f/� 7 /C./\/-t•, CJ .
Address(NUM rand Street) . Company .
> 2U1s/L4Lit_ TUI It1ric) (bt`)) '/3--11400c,
City,State,and ZIP Code Telephone Num er E-mail
I E.SELLER(S)/GRANTOR(S)
JAY Fl PFRS
IIer6-A'olnea�ppeagonnnve;ance cu7ent e j Seller 2-Nome as appears on conveyance document
ALd (Ilyuumberand((Strre ) -,LI{f �a . `/Yi Address(Number and Street)
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".
Sign rep slier, Signature of Seller
JAY Fl AS 10/08/9015
Printed Name of Seller Sian Date(MM/DD/YYY11 Printed Name of Seller Sion Date fAIM/OD/YYYr
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY -
JASON H. WILKERSON
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance d ument
656 Address BEACHFRONT DR
Add (Number and Street) Address(Number and Street)
EVANSVILLE IN 47715 -1:4
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL CF OSE J APPLY. J
YES NO CONDITION Sp • '
YES ,- NO CONDITION A, —.it
nj ❑ 1.Will this property be the buyer's primary Iii ❑ 3. Homestead syvty Mu
residence? Provide complete address of primary ❑ d 4.Solar Energy Heating/Cooling Sr' aptn
reside ce,includjg.county: n ❑/ 5.Wind Power Device
3 C- (1,�56✓� ,_4
AIdq�
(m-19.up b,11;feL I T•A ; Lj-7G1,,r- /'; / jC,�_❑❑ 6. Hydroelectric Power Device`� 'a IU�L Jam" / J C� (7 7.Geothermal Energy Heating/Cooling Device
City S nee' be ❑ 8. Is this property a residential rental property.
❑ to 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide ❑ 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)
24/ 9-3/- 30o co/ (/ 9 - a29
City,State ZIP Code County
Primary property owner contact name E-mail