Homestead_Banister INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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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 CHRISTINAeREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
LE:SEELER(S)/.GRANTOR(S)•t- z-. , _ - — -. : 77-'------77: - Y-f —
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drew T Williams
ler I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
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ddress(NUmberatM Street) Address(Number and Street)
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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 re' d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller rte— ---1 Signature of Seller
Andrew T Williams \ /?/?L4lo _
Printed Name of Seller Sian Date tM.v/DD/inn Printed Name of Seller Sian Date(MM/DD/YYYY)
tFCBUYER(S)/GRAN;TEE(S)1L=AP.P;LIGATIONIF,ORIRROP,ERW TAX<DEDUCTIONSL IDENTIFYAWITEMS_THATIAP,P;GYL
Ian Banister
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Bvyerl-Name as appears onronveyancedocument Buyer 2-Name asappears cony an m [X
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THE SALES BILLOW RE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY A L OF THOSE THAT APPLY.
YES _NO; CONDITION? I LYESsc- 11...,COND TION
❑ 1.Will this property be the buyer's primary 0 3. Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑
1006 S Main St 5.Wind Power Device
Address(Number and Street) ❑ is 6. Hydroelectric Power Device
Ft. Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana 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)
ac, — lg —a Lk—a01k-bazo-g l - o.1--(c)
City,State ZIP Code County
Primary property owner contact name E-mail