Homestead_Kolb�
CHRISTOPHER E. CARL
Neparer of rhe Sala Dinlmure Form
101 PLAZA EAST BLVD.. SUITE 102
Addras (A'umber and Street)
EVANSVILLE. INDIANA 47775
liry, Sra[G and Z/PCode
C7HARI FS H CONF
Seller 1- Name os appmrs on ronveyonce documen[
207 E Main Street
Address (Number and StreeJ
■ .� � R.�. �
Title
TRUE TITLE S
Sellcr 2- A'ame as oppeurs on tonvryonte documen[
and5beet)
cod�
E moil
Under penalties of perjury, I hereby certify tha[ this Sales Disclosure, ro the best of my knowledge and belief, is true, correct
and comQlete as required by law, and is prepared in accordance with IC 64.1-S.S, "Real Property Sales Disclosure Act".
2
VINCENT GENE KOLB
Bvyer 1- Name as oppmrs on convewnte dacumen[
207 E. Main Streei.
Addras(Numberond5veet)
Francisco, Indiana 47649
S{gnamre o(Seller
as appears on
Ciry, Smtq and ZIYCOdc
THH SALFS DISCLOSURE FORP7 MAY BE USED TO APPLY FOR CERTAI\ DHDURIO\5 FOR TNIS PROPERTY. IDE�TIFY ALL OF THOSE THAT APPLY.
� ❑ 1. Will [his property be the buyer's primary
residence? Provide comple[e address of primary
residence, including county:
Addrm (M1'umber and SneeQ
Francisco. I diana 47649 GIBSON
Liry,SmteZl ode County
❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vaca[ed,
including county:
Addrm (A'umber and Svee[)
Ciry.SmmZIPCode Caunry
0
❑
❑
❑
❑
❑
2
❑
0
0
�
❑✓
�
3. Homestead
4. Solar Energy Hearing/Cooling S:
5. Wind Power Device
6. Hydroelectric Po�ver Device
7. Geothermal Energy Heating/Coi
8. Is this properh� a residen[ial rer
9. Would you like to receive tax sc
property via e-mail? (Provide ca
below. Pleose see instructions for
A'ot availa6le in all counties.)
-ao -�o � aoo ao�
mnmclnomc
Under penalties of perjury, l hereby certify that this Sales Disclosure, to the bes[ of my knowledge and beliei
and complete as required by law, and is prepared in accordance with IC 6-11-S.S, "Real Property Sales Discl
Spouse informa 'on ocial Security and Driver's Li Other numbers are not necessary if no Homestead
being fil �
�z�
5 , aNreofBwerl SignaNreo(Ruyer2/Spouse
VWC'FNT (;FNE KOf R 04/ 29 �/2Y0YY1)5
Las[Sdigitto(Buyer2/SpouseDnver's S[a[e Lasti
License/ID/OtherNumber Num6er Lirense/fD/OfherNum6er
�,e
\
e Device
property?
nents for [his
't informadon
re information.
..
E-mail
is true, correct
sure Ac[". (No[e:
)eduction is
sjgn Dare (Ha/no/YVYY�
of5otia15eturiq•