Homestead_Strickland (9) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D#:PRTP,ARE, ice — — — = r_,..___ — --
Dana McBride Closer
Preparer of the Sales Disclosure Form Title
606 Main St. Dubois County Title Co.. Inc.
Address(Number and Street) Company
Jasper. IN 47546 812-482-1696
City,State,and ZIPCode Telephone Number E-mail
!SELLERS GRANTOR(S� �. ,, -,�.-r T?�— . . -F 177.-
Jordan Williamson _ L�..__.y. __,____-..
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
gift e 55—' 5.
Address(Number and Street) Address(Number and Street)
O4 Pan dL
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".
Sature of Seller Signature of Seller
n Williamson 9/12/16
ted Name of Seller Sian Dare(AIM/On/YYYY) Printed Name of Seller Sian Dote(MM/on/YIYY)
_F;.BUYER( GRANTEEU�_AP,PLICATION;B ORS.PROPERT}`(TAX;DEOU.CTIONS_IDENTIF]'AL`L ITEMS THAT,AP,PLY�-` R`
Marie Ann Strickland
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyance document
7/ 3s. rntrl5+
+ddregs(NUm er and Street) Address(Number and Street)
VIrICC-�ui, . IN 47(
q
THE SALES DISCLOSURE FORM,MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. �i , �t
YES ENO CONDITION I YES NO CONDITION G/B ■ , O�°•
•I✓ ❑ 1.Will this property be the buyer's primary [ ❑ 3. Homestead S �Q� i1
residence? Provide complete address of primary ❑ L...74>Solar Energy Heating/Cooling % a'`
residence, including county:
❑ ❑ 5.lltind Power Device Oh.
Address(Number a. .Cr e -' D h ❑ p/6. Hydroelectric Power Device
Vi
l---\t l'\ i "Cor, ❑ 2"----7.Geothermal Energy Heating/Cooling Device
City,State ZIP CP de Count'
❑ . Does the buyer have a homestead in Indiana to be Is this property a residential rental property?L,!�2
vacated for this residence? If yes,provide ❑ �.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 O -/ _ 67-J i-DDd. i/a- a07°,{/J
Primary property owner contact name E-mail