Homestead_Smith (14)INDIANA SALES
SDFID:
Beckv Kina Closinq Services
Preparer o/the Sales Dlsclosure Fartn Tltle
_7820 Eagle Crest Blvd.. Ste 201 Reoional Title Services
Addreu(Numberand5tree[) Lompany
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Evansville.IN 47715
� E-matl
Seller 1- Nome as oppears an ronveyvnce dotument
William L Mitrhall �
Seller2�Nameasappearsomm�veyonredacument �
9902 E Warrenton Rd. I 9?0? E WarrPnton Rd :
Address (Number and Strret) Address (Number and SveetJ i
HaubstadL IN 47639 Hauhstadt. IN 47639
Clty, Smtg and ZIP Code
Under penalbes of perjury, t hereby certify that khis Sales Disclosure, to the best of my knowledge and belief, is true, correct
�a d complet,e/ �a �re�q�uir�ed �b�y law, and is prepared in accordance w' h IC�� .1-S ,"Real Pr "� Sate D' e osure Act".
�t-s'�°�/I.lJ- c./tiCt�j' �(/��T�/���,G.�G���
�Ignamre oJSeller /SlbnaNre af5eller
Shara l MitehPll 12I2I2015 William I Mitchell I '12I2I2015
Mark Smith I iara smrth
Buyer ]- Nome as appeors on ronveyonce dacumen[ Buyer 2- Name as appears on ronveyanre dxument
342 E 800 S I 342 E 800 5
Addrecs (Number and Street) Address (Number and St
Fort Branch IN 47648 Fort Branch.IN 476
Ciry, Smte, and ZlP Code Ciry, Smtq and ZIP Code
THE SALFS DISLLOSURE FORM htAY BE USED TO APPLY FOR CERTAIN DEOORIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE
✓� � 1. Will this property be the buyer's primary
residence? Provide complete address of primary
residence, including county:
7709 F WarrPntnn Rri _
AdEress (Number and Street)
Haubstadt IN 47639 Gibson
Ciry, State ZIP Code Caunry
Q� 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
342 E 800 S
Address (Number and Street)
Fort Branch IN 47648 Gibson
Clty, Smre ZIP Lode [ounry
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3. Homestead "viy�
4. Solar Energy Heatlng/Cooling
5. Wind Power Devite
6. HydroelecMc Power Device
7. Geo[hermal Energy Heating/C
8. Is [his property a residen[ial r
9. Would you like [o receive ta�c �
property via e-mail? (Provide c
6elaw. Please see instructions fi
Notavaila6le�in all counties.)
'_3-/�-�
N owner conln[[ name
Under penaldes of perjury, I hereby cerdfy that this Sales Disdosure, to the best of my Irnowledge and 1
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales
Spouse information, Social Security and Drivers License/Other numbers are not necessary if no Home:
being filed.) %��h ���� �
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SlgnaNre of Buyerl noare oJBuyer2/Spause
dine Device
WI proper[y?
tements for this
itact infarmatian
more in%rmation.
E-mall
, is hve, correct
�sure Act". (Note:
Deducdonis
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