Homestead_Novotny INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Lynette Murray Processor
Preporer of the Sales Disclosure Form Title
4962 Lincoln Ave First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 812-490-8485 theteam@firstadvantagetitle.com
City,State,and ZIP Code Telephone Number
E-mail
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E.SELLER(S]IGRANTOR(S) -. —
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Darin P Wagner
Se'er 1-Ngrneasreors on tepvenunce 4)cu t Seller 2-Name as appears on conveyance document
13 ►'vatf1 bac\rt Dr,
. ores(Number and street) Address(Number and Street)
tAa-n SY i I Lp
Under penalties of perjury,I hereby certify that this Sales Disclosure, to the best of my knowledge and belief,is true,correct
and co fete as r bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
dV�/ / Ir�
Signature of Seller /� fl,� Signature ofSelle
Darin P Wagner O
Glenda Laskey Name of Seller Sian Date(AMM/Dao'vn) Printed Name of Seller Sian Date(MM/DD/in')
F.BUYER( GRANTEE(S).',APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY .•
_
Bryan J Novotny �yt
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on convl�ap�e1cufent ED
ill �Q v . ,�1.S* $$��qy
Ad e.(Number•nd Street) Address(Number and Street)
liii.• 1
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY At.LQI198altAx.1P?•(lYAUDITOR
YES NO CONDITION YES NO CONDITION VU
CJ ❑ 1.Will this property be the buyer's primary 1E1 ❑ 3. Homestead
residence? Provide complete address of primary ❑ fl 4.Solar Energy Heating/Cooling System
residence, includin ounty:
I I l - V (•Q ❑ fl 5.Wind Power Device
Id essNumberan Se ft) ? ❑ IA 6. Hydroelectric Power Device
�
a— `-f c 9 f ) UN ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code I County
❑ 0 2. Does the buyer have a homestead in Indiana to be ❑ B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ IA 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)
City,State ZIP Code County 0Q10- 19 -31 -303 -D00. 31 L oo9
Primary property owner contact name E-mail