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Homestead_Brokaw INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 DsPREPARERIie`t't. �' ,.} §.ua' .6ixin "`2�a1i" ': :} e �r ^,. etn'`c'r•� c__a..szy_;: na�Y LANA C. HARPER CLOSER Preparer of the Sales Disclosure Form Title 5231 Oak Grove Rd., Ste.A TOTAL TITLE SERVICES,LLC Address(Number and Street) Company EVANSVILLE, IN 47715 812-468-8485 City,State,and ZIP Code Telephone Number E-mail ETSELEER(S)%GRANTOR(S)`WS e4: K` t`. :t s M 2 '`-: "a"-3 a g--,,, ' _:_'fiitl E., 1.`.-! Daryle R Hawkins Marianne Hawkins Seller I-Name as appears on conveyance document Seller 2-Name as appears an conveyance document Li Il8/ OAovvntf f-I Address(Number an Street) ii' y/Ad'�dress(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 prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". Signature (Seller Signa'areofSeller flaryle R Hawkins /� Marianne Hawkins 7-4 —/7 Printed Name of Seller Sign Date tMM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYY1) A 'F:,BUYER(S)'/GRANTEE(5)SAP,P,L•IGATION!FORiP,ROI?ERTiY;TAX?DEDU6TIONSgiII)ENTIEYiAL'LRITEMS;THAVAP,P.LYreie _.,z` Frederick J. Brokaw Nancy J. Brokaw Buyer I-Name as appears on conve nced urgent Buyer 2-Name as appears on conveyance document .�0, N. First S`� ((///�'� Address(NumberandStf t) Addressctfils ) owel9S U �I�t �A �7�D�1 J`- ��/ 1/ �X/ t THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE% APµ• ©10/, • YES NO 1.Will I YES NO CONDITION JJ�,p/t/C,-, • IC ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead Un/T residence? Provide complete address of primary ❑ 0 4,Solar Energy Hearing/Cooling Sge�m r ence i ding county: ❑ /T /-11l szt_' S.Wind Power Device pR J�le�eb�r/�n��ur/vyGtr'eet�N t�1/�5 6i hsbn ❑ 0 6. Hydroelectric Power Device UI' (/ /!t/ ❑ 12 7.Geothermal Energy Heating/Cooling Device City.State ZIP Code County 1:11 I�,'t/fl 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. Not available i all counties.) Address(Number and Street) City,State ZIP Code County Primary pruperty owner contact name E-mail-