Homestead_Ralph INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Becky King - Closing Services
Prepares of the Sales Disclosure Form Title
7820 Eagle Crest Blvd., Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 becks.kinceregionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
iESEL'LER GRANTORS) z 7y _.Z,F. - _ -_ -7)-`. „= 7 3-2 7 7 1 7 7:-.7 7.
Marlene C Ralph
Seller 1-Name asappears an conveyance document Seller 2-Name as appears on conveyance document
89?E State Road 68
Address(Number and Street) Address(Number and Street)
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 bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�l \t ,.,c C_- .mot/,
<Sjgnowrre of Sallee Signature of Seller
Marlene C Ralph 1?/05/2016
Printed Name of Seller Sian DateLMM/DD/YYYY) Printed Name of Seller Sian Dote(MM/DD/M11
FAU,Y,ERNTIGRANTEE(S); APPLICATION[ ORiBROPERTY_TAVDEDUCTI0N3 )ENTIFYALIni iSITH VAPPLY
John D. Ralph
Buyer 1-Name as appears on conveyance document Buyer 2-Name asappears on conveyance document
892 E State Road 68
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF TH A LY.
YES NO CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary 4 0 3.Homestead n��/ ��
residence? Provide complete address of primary 4. Solar Energy He P o li System
residence,including county: ❑
s.Wind Power Devi
R92 F State Road 68 c-
Address(Number and Street) ❑ Q 6. Hydroelectric Po 1/ pp
Haubstadt, IN 47639 Gibson ❑ Q 7,GeothermalEneer Heating/Looting Device
City,State ZIP Code County
❑
ig� 2. Does the buyer have a homestead in Indiana to be ❑ $ Is this property a residential rental property?
vacated for this residence? If yes, provide ❑ £ 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) ,c(0 -^ ^ v s-_ ^w-cco ^ 9&oa
Cy,State ZIP Code loamy
Primary property awner contact name E-mail