Homestead_Harnishfeger Jr INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
.'D:�PREPARER- "_ ::3.. a:".tvir,r577,4,2 14i.,*;-A,1' -� _ z . .�.._._ -:1 i _ , z>:--- e•^ t
Kim Loesch Processor
Preporer of the Sales Disclosure Form Title
2301 N Burkhardt Rd First Advantage Title
Address(Number and Street) Company
Evansville. IN 47715 (812)490-8485
City,State and ZIP Code Telephone Number E-mail
.t..-f i i E R(S)%G E A N T O R(S]n =K .177:c r _.. . ;'." _.. • __ s. - . .i•i.a i n
Kristen Fleetwood Zehr f/k/a Kristen N Fleetwood
Se` -Nam asappeO on Conveyance docent �� 1` 4 Seller 2-Name as appears on conveyance document
TL i \-. v�J
A (Number aand Street( _ I Address(Number and Street)
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Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
complete required by la",and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
A / y
Signature ofsele ( z l Signature of Seller
Kristen FIeetwo d Zehr d\ l�IT
Printed Nameo Seller Sion at•(M.H DD m Printed Name Seller - Sian Date Val/DO/MI
:F.BUY.ER(S)/GRANTEE(S), APP_LIGATIOR FOR%PROPERTY_TAX.DEDUGTIONS dDENTIEY?ALL ITEMSTHATrAPPLY ,t _ ._ - 'CI '
Robert Gene Harnishfeger JR. Robin Harnishfeger
Buyer y-Nome as aynrs on Conveyance dagiment Ruy r Name as appeo •on conveyance document
��/r��JJ/ `/,/ bu h �l L ■ Av 9, ) I ._•
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Addr s(Number and Street ( Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USEDTO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE T& APPLI!��EQU`e
YES NO CONDITION I YES NO CONDITION C[iiSON nn -
Mee ❑ 1.Will this property be the buyer's primary q ❑ 3. Homestead UNnez
r Idence? Provide omplete address of primary ❑ NI 4.Solar Energy Heating/Cooling System/TOR
1 ")- es R A--yhGludil QUn
l`�V1— �1 �� I 1 l�V. ❑ 12 S.Mind Power Device■
Ad. s Vumbera dStreet 1 `y'i 1 r ❑ El 6.Hydroelectric Power Device
- G e. - t'S ` V4' • - (g1❑ Q 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code , County
❑ 111 2. Does the buyer have a homestead in Indiana to be ❑ ig B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ g 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)
City,State ZIP Code County
cZ-33—oC—a66—COO. 7X7- a65)
Primary property owner contact name E-mail