Homestead_Bennett INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D: PREPARER
Kathy Masterson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 Kathy @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Charles N.Williams Charlene Williams
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2198W100S 2198W100S
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Princeton, IN 47670
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 Real Property Sales Disclosure Act".
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Signature of Seller 4- ( C Signature of Seller
Charles rinse N.Name 8/31017 Charlene Name 2f 01101 (�
Printed Name of Seller Sign Date(MMAJD/YYYY) Printed Name or Seller DULY >9J p{f( i � Y)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL I A ce for transfer
ichael R. Bennett ) Connie J. Bennett
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ars on conveyance document Buyer 2-Name as appears on .:{ :
veyance docum nt
4201 N Congress 4201 N Congress /:,ty u i.j . Auditor
Address(Number and Street) Address(Number and Street) -r 1 �j• • -, '
Evansville, IN 47711 Evansville, IN 47711 Par — . I
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
ES NO CONDITION YES NO _ CONDITION
❑ 1. Will this property be the buyer's primary 0 3. Homestea
residence? Provide complete address of primary
❑ )4. Solar Energy Heating/Cooling System
residence, including county:
❑ 'ffl 5. Wind Power Device
2198 W
Address o(Number and Street) ❑ r 6. Hydroelectric Power Device
Princeton, IN 47670 I Gibson ❑ 9 7. Geothermal Energy Heating/Cooling Device
City, State ZIP Code County ❑ 9 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ O. 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete i property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
(.111 I r ( 'i, II,1. v S Not available in all counties.)
Age s(Number and,Sttreet) lk�
t-VOI*IIL( /IVyf/)-) / l Viimi D .24, - i1 - 75t - io,t- ooY. Gad? -° e- 7
ty,State ZIP Code County Primary property owner contact name E-mail