HomeMy WebLinkAboutHomestead_Virden INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER . _ - _ ,
CHRISTINA LATHAM TITLE CLERK '
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE,IN 47715 812-402-4553 CHRISTINA(TREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR[S)
Estate of 1 oretta L Richards
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
X(0eie0 l G</ vCo SowN
addle-is(Number and Street) Address(Number and Street)
,..\--Lowrts,/«
Under penalties of perjury,I 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.S,"Real Property Sales Disclosure Act".
S"-atdreofSeller,�. Signature of Seller
PROPERTY. IDENTIFY ALL OFTH I • A •�• ,.
_ YES \�`�0" CO,YOIT Ox Y So COYDITION�I d❑ 1.Will this property be the buyer's primary Ertl 3.Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
403 E Illinois
Address(Number and Street) ❑ ig 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson n lig 7.Geothermal Energy Heating/Cooling Device
City,State ZIP ode County
El 2.Does the buyer have a homestead in Indiana to be ❑ 8 Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ gi 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)
86-ta-18 -aOi - 004- .3ac-c&&
City,State ZIP Code County
Primary property owner contact name _ E-mail