Homestead_WeaverPreparer oJ[he Salet Dtrclosure Farm
7820 Eaale Crest Blvd Ste 201
Address (Number and Stree[)
Evansville. IN 47715
Ciry, Smtq and ZIPCode
�PC�IP B r0(1IIPf
Sel/er I� Name as appmrs on ronveyance dacument
9166 S 100 E
Address (NUm6er and StrttrJ
Ciry, Sm:q and ZIP[ade
r�ve
Seller 2� Name as apPears an rwveyvnce dxummt
Addras (Number and Strtt[)
Ciry, Srnre,
E-mall
Under penalties of perjury, I hereby rtify [hat this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complet�uired by la�r dis;prepared in accordance with IC��S.� �al Property Sale Disclosu ie Act".
�, ��L
SignaNreofSefler � SignaNrepf311er � �
Nicolas D. Weaver I Laura Weaver .!I '
Buyer 1- Name ai appmrs w ronveyana document Buyer 2� Name as appears an ronveyance dacvment
a08 S west Sc I aot3 5 wesc 5t.
Address(NumberandStrxtJ ' Add�as(Num6erond5c
Haubstadt IN 47639 Haubstadt. IN 4763
Ciry, Smrq and ZIPCode Ciry, Smtq ond ZfP lode
THE SALFS UISCI.OSUFE FORM MAY 6E USED TO APPLY FOR CERTAIN DEDUCf10�5 FOR
�✓ � 1. Will this property be the buyer's primary
residence? Provide complete address of E
residence, including county:
Addr¢s (Nvm6er and S Vett)
Ft. Branch IN 47648 Gibson
Ciry.Smm Z/PCOd< Counry
Q � 2. Does the buyer have a homestead in Indiana to be
vaca[ed for this residence? If yes, provide
complete address of residence being vacated,
including county:
4�6 S West St
Addr� (Numbet and Svttt)
Haubsiadt.IN 47639 Gibson
Ciry.Smte 9PCade Counry
2,�
THAT
4. Solar Energy Heatlng/Cooling S7
� Q 5. Wind Power Device
� Q 6. Hydroelectric Power Device
❑ ❑./ 7. Geothermal Energy Heatlng/Cooling Device
� QJ 8. !s this property a residentlal rental�property?
� Q 9. Would you like to receive tax stateinen[s for this
property via e-mail? (Provide conta[t informo[ion
6elow. Please see instrucdons jor mire information.
Not available in all counties.)
a�-i9-a�'-�-� �o0 39 0 -oa5
�
Under penal[ies of perjury, t 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". (Note:
Spouse information, Sotial SeturiTy and Driver'S Litense/Other numbers are not necessary if no Homes[ead Deduttion is
�//�/i1 �L_ // V 't---' ��lt.0
Signa[ureof uyerl 1 r^ Signature
nu..,.i�� n �n�e� ,a ll ( 13 I �� I a i�ra WE
License/ID/Other Num6er Num6er
�useDriver's Smre Las[
Num6er (