Homestead_Hunt (3) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER .
R. Jeff Dodson Closing Agent
Preparer of the Sales Disclosure Form Title
1911 Lincoln Ave Clear Title Company
Address(Number and Street) Company
Evansville, IN 47714 812-423-8854
City State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
Doris R Blake
Seller I-Name as appears on conveyance document 2-Name as appears on conveyance document
3-La 8-to. `f71 Eadrit- -a-.d i/7 .
Address(Number and Street) Address(Number and Street)
City,State,and ZIP Code City,State,and ZIP Code
--y A-e� /�7
Telephone Number �� — �Q;y-—,Fj0 Gj E-mail Telephone Number E-mail
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 with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller R r �2 Signature of Seller
4oris Printed Name of Seller San Date(MM/DD/YYY17 Printed Name of Seller �� , i.tan Date(MM/DD/rrvrl
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY A T M TH .P rJ '
aylor W. Hunt
\ Myer]-,,uinc as appears on conveyance document Buyer 2-Name as appears on conveyance doe ent
434 S. Gibson St MAYO 2017
Address(Number and Street) Address(Number and Street)
Oakland City, IN 47660 (I
itzar
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. Home
residence? Provide complete address of primary ❑ 1.{1 4.Solar-Energy Heating/Cooling System
residence,including county: ❑
434 S Gibson St S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Oakland City, IN 47660 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIPCode County
SI ❑ 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 ❑ 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.
Hwy 64 East Not available in all counties.)
Address(Number and Street)
Princeton, IN 47670 Gibson 02 4- - /y- 1? - Jo/ - 00 0. 3:1 _00 7
City,State ZIP lode County
Primary property owner contact name E-mail