Homestead_Abu-Hussein INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Tide
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINA(WREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
Brenda J Cremeans •
\(6'eller N�easappea on cgnv_eyvq{'r document 0 Seller 2-Name as appears on conveyance document
Address( beer and Street)6//�CJ4/�/J/� C Address(Number and Street)
X �e zgg7A-- -74 70
„
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a d co •lete as required by law and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller r Signature of Seller
Brenda.1 Cremeans - -Printed Name of Seller Sian ate(M. OD/EMI Printed Name of Seller Sian Dat MM/00/117Y)
F. RA E S`APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE? •HIT PPLE U _
Manelle E.Abu-Hussein 1
erI-Nnm,al a+, nrt "'a"u5'jnce document Buyer 2-Name as appears on conveyance document
K 3oq (A) Brur6;QId A02 Apr 00 DEC 1 2016
/
Address(Number and Street) Address(Number and Street)
Pr;nce -on , IN : 4 '7L07o
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
0 ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System
residence,including county: ❑ NI
2563 W 50 S 5.Wind Power Device
Address(Number and Street) ❑ Fl 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ ID 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 Li p 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)
.26-// -/s- doA -o a0. 5 i -o 17
City,State ZIP Code County
Primary property owner contact name E-mail
•