Homestead_Chapman (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
THOMAS L.MONTGOMERY GENERAL MANAGER
Preparer of the Sales Disclosure Form Title
, 101 PLAZA EAST BLVD..SUITE 102 TRUE TITLE SERVICE. LLC
Address(Number and Street) Company
EVANSVILLE. INDIANA 47715 812-402-6555 closings(a)truetitlein.com
City,State,and ZIP Code Telephone Number E-mail
E?SELTEER(S)/MAW. OR(S) _ _ .17:;. ._ _ -. . _ 1 _ - -_: ;1_ _ , i _ -.7. _ ,14
KATHY EVANS
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3600 N 225 W
Address(Number and Street) Address(Number and Street)
PATOKA INDIANA 47666
Under-penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and compl teas r uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller ` Signature of Seller
KATHY EVANS 08/ 15 /2017
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DDMTYI
iFz BUYER(S)°/GRANTEE(S) AEFL[CATIONIF,ORLRROEERTY zTAX'DEDUCTIONSIDENTIFYALtiITEM y ;PI.: _, :, _. _
MARCIA K.CHAPMAN
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
3600 N.225 W, AUG 22 2C"
Address(Number and Street) Address(Number and Sweet) t t
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
7j ❑ 1.Will this property be the buyer's primary IZ ❑ 3.Homestead
residence? Provide complete address of primary ❑ IA 4.Solar Energy Heating/Cooling System
residence,including coun ty:
3600 N 225 W IN ID S.Wind Power Device
Address(Number and Street) ❑ ( 6.Hydroelectric Power Device
PATOKA. INDIANA 47666 GIBSON ❑ Z 7.Geothermal Energy Heating/Cooling Device
City;State Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 51 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) Ir-tI/—J��—I-J
MARCIA K.CHAPMAN V V a 3 30) —WNW -o ,i
City,State ZIP Code County
Primary property owner contact name E-mail