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INDIANA SALES DISCLOSURE FORM SDP ID: Page 2
D.PREPARER • .
Abbey Moore Closer
Preparer of the Sole;Disclosure Form Title _
3101 N. Green River Road Suite 130 Columbia Title
Address(Number and Street) Company
Evansville. IN 47715 812-471-8563 abbeyecolumbiatitlegroup.com
City•State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S) - - '
Barbara.1 McEllhiney
rI-Name as pears on conveyer ument Seller 2-Name as appears on conveyance document
A (Number and sne t) Address(Number and Street)
nv/(
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and contplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
7/41 /''Zt1,i
e of Se er /� / Signature of Seller •
Barbara.l MrFllhinev 7/�`/J//(
Printed Name of Seller Sian i.4M/Dp Printed Name o Seller Sian Date l.4.4/DDM7Y)
F.BUYERIS)/GRALI&TEE(S).-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ArT M THY A il' Y. I
•ache-I Fidler
•uye , . • —. on cony •d„-document Buyer 2-Name as appears on conveyance document
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� - .I1 • OCT7 7016
AQdrysi(NUmberand Stre'tki , Ii Address(Number and Street)
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 125—Nu—N. ; ..
iii ❑ 1.Will this property be the buyer's primary , ,gi ❑ 3. Homestead
residence? Provide complete address of primary � • • yr -eating/Cooling System
residence,including county: .
❑ 12 S.Wind Power Device
Address(Number and Street) ❑ E 6.Hydroelectric Power.Device
❑ E 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ ® 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 ❑ 0 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.
•ot available in all counties.
Address(Number and Street) C)
City,State ZIP Code e.unry X —/a —fg -3a¢_ Q0 7„/8a -02 j$
Primary property owner contact name -mail