Homestead_Chambers INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Kim Loesch Processor
Preparer of the Sales Disclosure Form Title
2301 N Burkhardt Rd First Advantage Title
Address(Number and Street) Company
Evansville. IN 47715 (812)490-8485
Oty,State,and ZIP Code Telephone Number E-mail
T...SE111!ER15176-TOVRTALS37.17.1_ =LT.=.4-7-":, —sliCtir i7.77-- JET-7'-77 CL-M777.- 757-C3E-ril s. 7,J317-- 77 1.-'::::7".7:
Wayne Keith Gwaltney
Seller I-Name as appears on con yance document Seller 2-Name as appears on conveyance document
dress(Number and Street,
ill
)Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
___
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and omplete as required by I,s ,and is prepared in a cordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signatur-'.f Seller Signature of Se ler -
A i . s. . . .,to 1- g ., hat,‘-,,,," 1,,.I t -- / / . / - /A-L_ , ./ - ez0,444,7,
SINameof Seller Sian Date MM/DO 2,enroor Printed Name of Seller ASIIIIMW Sian Da, DAst/0 ,
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Tessa J Chambers
Buyer 1-aflame as at 65 on iv once cument Buyer 2-Name as appears on conveyance document
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Addrumber and eet) Address(chrumue nc.Mil
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR T I IS PROPERTY. IDENTIFY ALL OF THOSE THAT '.
YES ,' CONDITION YES / NO CONDITION
07/
il 1.Will this property be the buyer's primary
0 3.Homestead
41
residence? Provide complete address of primary LI 12I 4.Solar Energy HeatinVklig Syste
303 residenoe74ncluding cop9IT: ‘..._.)
111 tg S.Wind Poewer De 'if 20/2
Lk)• _5(Li rv't ili tit' C—W . Ws
AddressMeld Street) I
rkS V t (1 f _TN 471,(0-C 0 g 6.Hydroelecti'fa A9 4#:%, )"v;e
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, 9 E 7.Geothermal Eller! •i t*.t ?NO. . ci Device
cio;State ZIP Code County k
El IN
0 Li 2.Does the buyer have a homestead in Indiana to be 8.1s this property a residentrikontal property?
vacated for this residence? If yes,provide Ei 171 9.Would you like to receive tax saglents 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)
R Lo- I 1 - i go I coo i 0. Q
City,State ZIP Code County
Primary property owner contact name E-mail
I .