Homestead_Kiesel (20) INDIANA SALES DISCLOSURE FORM SW ID: Page 2
D:PREPARER - - -
Kim Loesch Processor
Preparer of the Soles Disclosure Form Title
4962 Lincoln Avenue First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 (812)490-8485
City,State,and ZIP Code Telephone Number E-mail
-E.SELLER(S)/GRANTOR(S) 1
Steven D Fngland Tam I"Fngland -
Se er�a5 appears-�n�docum4( er (u a as appears on conveyance document
dress(Number and Street) J( Address(Number and rsStreet)
Under penalties of perjury,t 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 D'sclosure Act".
_ Ar...� �_ .I (c iont,h-y R �
Signature of Seller l ((�� Signature ofSelle/ /
Steven 0 Fngland 1�I,�i) `Y Tammy L England Pgal-. 1 •
Printed Name of Seller Sian te(HH/OD/1' J Printed Name of Seller f Sia s: 'voo
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY.TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY- ` ,
,�tiavis A Kiesel Karen Kiesel DEC 5 21)16
(\ C vryanced meat Buyer 2-Nyme as appears on onveyance document
Go a,� Jc
) � ( �� wc� I N
�(d¢m'(Number and trees) _
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF •- AS PPL
YES NO CONDITION YES .1 INDITION -
❑ 1.Will this property be the buyer's primary [si ❑ 3.Homestea I
residence? Provide complete address of prima • IS rA -I • - • a, "tegg/CIPIZOystem
J U I j ^IT resi e,. i ding county:
C arU .ail n ❑ 5.Wind Power Device
• rest(Numb rand Greet) �Q ' ❑ Q 6. Hydroelectric P.I -r D;ci,Antf'..
7.Geothermal En 4,414• i L/ Ice
Ciry,State ZIP ode P V❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this pr Brjy a residential rental property?
vacated for this residence? If yes,provide ❑ E 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: _
e ore information.
Not available in all counties.)
Address(Number and Street)
026 _Ig- 342 - 3 oo - 000; . 3C/ -O Ay
City,State ZIP Code Count s.