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Homestead_Lefler INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ID.P�rREPARER Q... � <. - „_-, o,a. -. `. , 'J R ilYYIdii (Q,Tt tAY3, CLOSER Preparer of the Sales Disclosure Form Title 1 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)/GRANTOR(S) .. a . ,a i . Mitchell A. Fills Amy E.Ellis Seller l-Name as apetuars on conveyance document Seller 2-Name as appears on conveyance document ap 3 Di 1 qtr Late_ 2 K1 1;(Number and Street) • a Number• •Str--t) Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and c mplete�as re d by law,and is prepared in accordance\with - 5,"Real Property Sales Disclosure Act". / F.BUYER(S)/GRANTEE(S).