Homestead_Holmes INDIANA SALES DISCLOSURE FORM SDF ID: _ Page 2
'-" ARE Y. -- T- , P A P A •-. -r.
_DiPREP.ARERc- .'.� __
Stacy Brown 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
City,State,and ZIP Code Telephone Number
E-mail
zE::SEbL`ER(S)J.GRANTOR(S)1 -;-. -2 •';7'--, _ --< ss 1 ° :-a.�'`i .t.i"=cs _ •/ «.����#. '- .:T
Angela Lynn Reavis - Scott A Reavis
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
8972 S 1125 W 8972 S 1125 W
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 by law,and is repared in accordance with IC 621-12,.5,"Rsal Property Sales Disclosure Act".
+indIvi o Sal- _ CSignatur'eufSellf
Angela l ynn Reavis 5 1( (1 Scott A Reavis 3 ( f
Printed Name of Seller Sian Date(MM/0D/117Y) Printed Name of Seller Sion Date(.1M/DD/T117)
tFs;BUYER(S1F/,GRANTEE(S),_,AEPL^IC ATIONIEMPROP,ERT.YLTAXFDEDUCTIONS IDENTIFY4nifliIE 1 T T.P-tiY.'�., '' t,-�u`
Shannon L. Holmes
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyance document
10080 S. Koch Drive JUN
Address(Number and Street) Address(Number and Street)
Posevville, IN 47633 �Z�l�
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. �°CUT�R
YES NO CONDITION I YES NO CONDITION
4 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
8
IS
972 S. 1125 W 5.Wind Power Device
Address(Number and Street) ❑ Fl 6.Hydroelectric Power Device
Owensville. IN 47665 Gibson ❑ Fl 7.Geothermal Energy Heating/Cooling Device
City,State Z Code County
❑ 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 ❑ Fl 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)
Le,—J 7 —�9/ — X60 00 'y3,a �� l
City,State ZIPCode County
Primary property owner contact name E-mail
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