Homestead_PattersonINDIANASALES
D.PREPARER
CHRISTINA LATHAM TITLE CLERK
Preparer o(rhe Sa/a Disdosure Form Ttle
4703 THEATER DRIVE REGIONAL LAND TITLE
Addras (8umberand Stree:) Company
EVANSVILLE. IN 47715
E-mail
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�Iler7-Nameasappearsanconveyan edxvment Selle�2-Nameasappearsanronveyancedxument
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\Arddr�' (A'umberand Stree[) Addrn's (NUmber and Stree[)
J(oa.�la�l Gf•� .IN �f7d60
�uy Sm[e,andLPC� Ciry.SmtQandZlPCode
TIOh N 6er E-mail TefeOhoneNUm6er E�mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comp�ete as rgqui�d by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sates Disclosure Act".
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FORPROPERTY
THE SALES DBCLOSURE iORM MAY BE USED TO APPLY FOR CERT.U\ DEDURIO\5 FOR THIS
�/ � 1. Will Chis property be [he buyer's primary
residence? Provide comple[e address of primary
residence, including county:
Ff1d F �^�ater St
Addrm (Kumber and Svee[)
Princeton.l 47670 Gibson
Ciry,SmreL Code lounry
� 2. Does [he buyer have a homes[ead in [ndiana to be
vacated for [his residence? If yes, provide
complete address of residence being vacated,
including county:
Address (Num6er and So-eetJ
Ciry, SmceTJPCade
Buyer 2� Name as appears an
nr� n � �A15
Address(Nvm6erandSVeet) -
Ciry.SmtQ
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❑ ❑✓
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IDENTIFY ALL OF TNOSH TH.1T APPLY.
3. Homestead �
4. Solar Energy Heating/Cooling System
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Enerw Heating/Cooling Device
8. Is Chis property a residentlal ren�al property?
9. Would you like to receive Cax sta[ements for this
property via e-mail? (Provide contact information
below. Please see instruc[ions(or more information.
Not availa6le in al! counties.)
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Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is [rue, correct
and comple[e as required b w, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse info '[ion, ocial Se urity and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being file . � '
5' pa� /' � , q r� �� �/^ / I I SjgnaNre o(BUye2/Spouse
V J
Pnn[edLegulNamPOfBuye�2/Spouse SgnDore(M.N/DO/YYYtj
Number License/ID/OtherNumber
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