Homestead_Beatty INDIANA SALES DISCLOSURE FORM SDF ID: Pace 2
DSP,REPi1RER' .-,_-- 97-79' j,°k. vr.r '-7 F ' 4_ g7:4-...�__ _.=.._7,3,c1
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd. Regional Title Services. LLC
Address(Nu mberand Street) Company
Evansville. IN 47715 812-759-5555
City.State,and ZIP Code Telephone,\'umber E-mail
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E`SEL-L-ER(S)fGRAn!TOR(Sjc'— -= � .-..i*� - —
Larry D Beatty
Seller I-Name as appears on conveyance document r] Seller 2-Name as appears on conveyance document
Ad,-gs(Number and Street) �f Address(Number and Street)
/fXb5t-5d71 7- / X76,,3
Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my know edge an a let,is e,correct
and complete required by law . d is prepared in accordance with IC 6-1.1-5.5,"Real Property SaletDisCJ,OSUre Act".
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Signatu Y _ • — Signature of Seller
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Printed Name of Seller Sian Date(MM/DD/YYYYL Printed Name of Seller CIBSOPI_C Gup1T Y S,on RetwfMde-,")D/YYYV) —
=@xRUYER(S)/GRADTEE(S),.:ARREI AT10N;E,OR'P,ROP.ERTIYETAX{DEDU.C-TIONSMMEN,TIFNAE'L°ITEMSETH_-1TeAPP,L1 Ji1—iT_o V
Alan J. Beatty Michelle Beatty
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyance document
12833 Cold Water Dr. 12833 Cold Water Dr.
Address(Number and Street) Address(Number and Street)
_
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary
r sidence, ' eluding county: ❑ 4.Solar Energy Heating/Cooling System
,53/ 5 re lo I ❑ fl 5.Wind Power Device
}�irlesss(Number dstr 4 1N Lt7i(I5� '� �-❑ 0 6. Hydroelectric Power Device
tress
/,: r/L ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,StateIP Code I County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 12 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)
J6-ad^ ^ I' ti_ ^ v._tl b ( t� 9
Ciry,State ZIP Code County -(1 (�^(J�Jt Jt/-) U'/ (�•/vIr/T\.'�, o J a////}'/f
Primary property owner contact name E-mail