Homestead_Crabtree (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
?D IPREFARER? °� n >' _
Becky King Closing Services
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd.. Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 becky.kingeregionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
>E::SELLER(S)%GRANTOR(S): ` , ti -,- - --.7
Patrick W.Yates
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
207 N 1st St
Address(Number and Street) Address(Number and Street)
Owensville IN 47665
Under ppenalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
-�afidcom• • • .s-requir e y aw,and is prepared in accordance with IC 6-1.1-S.5,"Real Property Sales Disclosure Act".
"Signature reofS Signature of Seller
Patrick W.Yates 03/29/2016
Printed Name ofSeller Sian Date(MM/DD/YYY!) Printed Name of Seller Sian Date(M.N/DD/YYY1)
IT BUYER(SW,GRANTEE(S) AP,PE ICAT10N IRORFPROP.ERTNTA%,DEDUGTIONS'IDENTIFYIACLEJTEMStTHATiAP,P A
Dwayne Crabtree
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance et�
1607 Address s(Brumfield Ave.
I�L////
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE r+q^^^ttt000��
YES NO CONDITION YES NO CONDITION UNTyNIIdITOR
❑ 1 Will:this:property.be.thebuyer'sprimary ❑ 3-Homestead
residence? Provide complete address of primary ❑ si 4.Solar Energy Heating/Cooling System
residence, including county: ❑ lig
207 N1st St S,Wind Power Device
Address(Number and Street) ❑ F4 6. Hydroelectric Power Device
Owensville,IN 47665 Gibson
7.Geothermal Energy Heating/Cooling Device
❑City.State 9P lode County
LE 2'Does'the:buyerhavea homestead:in:lndiana',to be ❑ 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
a6-/S-o7-/o/ - 000 cis-0 a3
City,State ZIP Code County
Primary property owner contact name E-mail
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