Homestead_Williams (9) INDIANA SALES DISCLOSURE FORM SDF ID:_ Page 2
D!PREEARERL_�__ --
Becky King Closing Services
Prepare:of the Saks Disclosure Form Tide
7820 Eagle Crest Blvd.,Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 becky.kinq(®ionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
.E SECER(S)/GRANTOR(Sf 7._: . .'s . a' °' • _ - -- , ..7•
Phillip A Huff Kimberly K.Huff
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
5407 War Admiral Dr same
Address(Number and Street) Address(Number and Street)
Wesley Chapel Fl 33544
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 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Phillip A Huff 08/04/2016 Kimberly K Huff 08/04/9016
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYTY)
,F::BUYER(S)%GRANTEE(S),=.AP,P,L`IGATIONI FOR-PROPERTYTAXiDEDUGTIONS IDENTIEY?AL(L',ITEMSTHATi9PPCY' .
Andrew T.Williams Lisa Williams
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1006 S Main St.
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
TA ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead �
residence? Provide complete address of primary ❑ TA 4.Solar Energy Heating/Cbo I e
residence,including county:
58?4 W SR 168 ❑ 0 5.Wind Power Device AUG 9. 2016
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ 0 7.Geothermal Energy Heatin: ooli • D• --
City,State ZIP Code County - 9fmllr
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a re egi 1.1
'�7' 'ie!• i TOR•
vacated for this residence? If yes,provide ❑ NI 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.
1006 S Main St. Not available in all counties.)
Address(Number and Street)
Fort Branch, IN 47648 96-i $ -0?-a oo-w5- 5 o a - o a■
City,State ZIP Code County
Primary property owner contact name E-mail