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Homestead_Miley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 hPREPARERL -- . LANA C.HARPER CLOSER Preparer of the Sales Disclosure Form Title 5231 Oak Grove Rd.,Ste.A TOTAL TITLE SERVICES, LLC Address(Number and Street) Company EVANSVILLE, IN 47715 812-468-8485 City,State,and ZIP Code Telephone Number E-mail tE,S LELE L'ER(S)`/.GRAN:TOR(S)l — - -- --- - --- — - - '--- -. Keith A Sandefur Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document 205 N 5 vn,-.1-6, s 1L-- Address(Number and Street) Address(Number and Street) O letsvi//e_, Jr( L/7460 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and c�oo/myw�plette�eAAas`/ree/quired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". S n LureciS fer Signature of Seller .�12 A , Sairtad- ia-IX/ � Printed Name of Seller Sian Dote(MM/DD/YYTY) Printed Name of Seller 5(an Date(MM/Daiwa) M,BUYER(S)7/.GRANTEE(S)`SAP,P,EIGATIONSEOI MOP.ERTYIT AXDEDUGTIONS 'IDENTIFY(ACEITEMS2THATAP,UN -'— Todd Miley Buyer I-Name as rs on conveyance d omen! Buyer 2-Name as appears on conveyance document ilye' 2 110 al a,� . ass(Numbe r ands reef) Address(Number and Street)(lthhtl �1, I �; 47(,��D pi THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAI'A YES NO CONDITION YES NO CONDITION COf/NT,, NI ❑ 1.Will this property be the buyer's primary TA ❑ 3.Homestead HUO/TOR residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System re. ence,incliutdingcounty: ❑ ) D� C� , .��r).1Ai 1 u 5.Wind Power Device L)DJCI ( )1 (F 1 NI ,f 7 f ,1( 5 ��j��� ❑ 6.Hydroelectric Power Device fJty,State ZIP Code �/(1 y 4 County ❑ 7.Geothermal Energy Heating/Cooling Device 2.Does the buyer have a homestead in Indiana to be ❑ 0 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. Not available in all counties.) Address(Number and Street) cap- IS-or/- /Ol - 6co. f8'7-nag. lily,State VP Code County Primary property owner contact name E-mail