Homestead_Hurt INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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LFNA C.HARPER CLOSER
Preparer of the Saks Disclosure Form Tide
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
E.=SELLER(S)'/GRAN;TOR(s) &k, l ;;:l : ";,^.M '". '1: 3t' 'e: ''- 1 -e-+cf-' - . y.
Randall L Caoehart Sarah l Canehart
Seller I-Name as appears on conveyance document Seller 2-Name as a
/?� / ao ppears on con nee docu ens
55 St X 113 l'_ �_OC a CI I
Address(Number and Street) Arress(Number and
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 6-1.15 e grope S es Disclosure Act".
"-Zi Z. .S6-L.el. a
Signature of Seller ' 7-3-17 Signature of Seller
Randall 7-3-/ndall L Capehart Sarah L Caoehart /y
Printed Name of Seller Sian Date(MM/00MTJ Printed Name of Seller ,Sign Date(M.M/DD/ITYY)
'ELBUYER(S)Y/GRANTEE(S) '"AEPCICATION?EOR.PROPERTY,TAX-DEDUCTIONS IDENT IFY'AEC ITEMS,THATtAPP1M 574`
Drew
��&/n S� y appears on convey d di: [
ess(Numib re,I ees)� !
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL orisiz ehhcA?hW..TY AUDITOR
ES NO CONDITION YES NO CONDITION
❑ 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
3 ^ g hi i resjc)e inc cou ! ❑
O /O /(7 5.Wind Power Device
dress Number;ndStreet El NI 6. Hydroelectric Power Device
Fi-,1/.•_ .6i1I '22 / /_t_S/
❑ ig 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
Ig
❑ 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.
Not available in all counties.)
Address(Number and Street)
City,State ZIP Code County a(C)_ II— I C- /CID^COY- CIZ
Primary property owner contact name E-mail
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