Homestead_Wright (9) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Stacy Brown Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services. LLC
Address(Number and Street) • Company -
Evansville, IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number . E-mail
>E:,SELEER(S)/GRANTOR(S)= "`-° --
Joseph M.Collins Mary M Collins
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
4364 S.600 W. 4364 S 600 W
Address(Number and Street) Address(Number and Street)
Owensville IN 47665 Owensville, IN 47665
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 of Seller 9 .14_.,l. f-fl - Signamre'ofSeBer
,Joseph M Collins fl-3c . (1 Mary M. Collins -3( (1
Printed Name of Seller Sian Date(•N/DD/YYYY) Printed Nome of Seller Sian Date(.N.N/DD/YYVn
. t
iF-BU�'ER S `G1tANTE£ 5 _APP.GI6ATION-EQR$ROP.ERTYTA\-
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION . BFLIQN
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestea
j
residence? Provide complete address of primary U 4.Solar Energy Heating/Cooling System
residence,including county: n
2995 S 675 W 5.Wind Power Device
Address(Number and Street) ❑ Fl 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson
7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Fl ❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Fl 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.
1709 Marie Ave. Not available in all counties.)
Address(Number and Street)
Evansville, IN 47711 Vanderburqh /b - /0- ,z ,)---- a oo -cote. /4 a - ox/
City,State ZIP Code County
Primary property owner contact name E-mail