Homestead_Helsley (4)INDIANA SALES DISCLOSURE FORM SDF ID: Pa e 2
�D?PREPARER_=� -- . . _
Allie Lamoinq Processor
Preporer o/the Sole Disdasvre Form Title
4962 Lincoln Avenue First Advantaae Title
Addras(NumberandSUret) �om��y
Evansville IN 47715 (
City, Sm[e, and ZlP Code TMephane Number E-moil
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� �E:SE�LER S'.GRANTOR S ' • '. ., _� _._ .- .«:_ ' , ,',,; - -- - _
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�� Kolian H HPdges
eller7 - Nome as appears on canveyvnce document Selfer I� Name as appears on com•eyvnre document
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Address (NUm6er ond Sveet) Addrus (NUmber and 5[reet)
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City Smre, and ZIP Code Lity, State, and Z/P Code
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Tele honeNumber E-mail Tele honeNvmber E-mail
Under penaltles of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, corcect
and co pl as required b law and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disdosure Act".
Signomre a(Seller 5lgnomre of5eller
R'intedNameo Seller SanDate NM DD PrintedNameo Seller SrpnOate ALN/OD
�� tF'-BUYER S' GRi1NTEE S� APPtiICATION FOR PR'OP.ERTY�TAX DED.UETIONS�IDENTIFY%ALL'ITEMS;THAT APP,GY °� �
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Debra J. Helslev
euyerl-Nameosappenrson o veyvncedocument Buyer2�Nameasappearsanconveyvnredocumeni
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ddr umber9� d St eet) � I� ' j���� Add�est (Number ond SVee(J ✓
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City, Sm[e, and ZIP Code Ciry. Smte, ond ZIP Code
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Tele honeNUm6er E�moil T¢le honeNumber $ [�,� E-mail
TNE SALFS DISCLOSURE FORN AIAY BE USED TO APPL1' i0R CERTAIN DEDUCf10N5 FOR TI115 PROPERTY. IDENTIFY ALL OF THOSE THAT AP�wJU
YFS NO CONDITION YFS NO CONDITIDY ryTy
❑ 1. Will this property be the buyer's primary � 3. Homestead �TOR
residence? Provide complete address of primary � � 4. Solar Energy Hea[ing/Cooling System
1 � � sidence, including county:
�. ❑ �✓ 5. Wind Po�ver Device
dd n��m , a U�y I^ I � � � 6. Hydroelectric Power Device
� ❑ � 7. Geothermal Energy Hea[ing/Cooling Device
Ciry,SmteZl Code Caunry
❑ 2. Does the buyer have a homestead in Indiana to be � �$• �s this property a residen[ial rental property?
vacated for this residence? If yes, provide ❑ 0 9. Would you like to receive tax statements for this
complete address of residence being vacared, property via e-mail? (Provide contoct informotion
induding counry: below. Please see instructions for more in%rmation.
Not avaifa6le in all counties.)
Address (Xumber and Scree�J
��— ��G -5�� o �,19—�'%
Ciry.SmteZlPCOde . Counp.
Primoryproperryawner ronm[[ name E-moil
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my kno�vledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deduction is
bei ng'(i l ed.)
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Signamreo�Buye�l ' Signomrro(Bvyer2/Spouse
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LastSdigicsofBu}'e�Z/SpouseDriver's Smte LastSDlgitso(SociolSecuriry
License/ID/O[herNum6er Num6er License/ID/OtfierNumber