Homestead_Hart INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
•
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services,LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
Ciry,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S)', ' 'E .
Adam B Scott Christooher W Scott
Seller I'Name as appears on conveyance document Seller 2-Name as appears o cony ace document
Address(Number and St � Address(Number and Street)
Q (.
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 • IC 6-1.1-5.5,"Real P operty Sales Disclosure Act".
gdovve—re of Seller Signature of Seller
Adam B Scott S't€- f—, Christopher W Scott c e. •r7
Printed Name of Seller Sign Date(MM/aa/YYYY) Printed Name of Seller g+�e gy(�M.H/OD/rvn)
\ L
F.BUYER S GRANTEE S -APPLICATION.FORPROPERTY TAX DEDUCTIONS—IDENTIFY ALL 1TE I�T A APP
Bradlee. Hart Dezarae N. Hart
JJ���
I . ....... ... . o n• conveyance document Buyer 2-Name as appears on conveyance dogient.
A f 1i2Oj/
434 E Walnut St. 434 E Walnut St. �YI
Address
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION , ..'f. ON
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.HomesteaI
residence? Provide complete address of primary • u • -- . - . a. •eating/Cooling System
residence,including county: ❑
5404 S 850 W S.Wind Power Device
Address(Number and Street) ❑ NI 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ 1g 7.Geothermal Energy Heating/Cooling Device
Ciry, ate ZIP Code County
2.Does the buyer have a homestead in Indiana to be ❑ 0 B.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.
y3-( WAL-r\)UT (.c Not available in all counties.)
Address(Number and Street) I
CA,�rsr,,, sJ( t_�£ . ( N - - b&os . A - !? - 07. - 3or - oo/. S64 -oJ-(
City,State ZIP Code i County
Primary property owner contact name E-mall