Homestead_May INDIANA SALES DISCLOSURE FORM SET ID: Page 2
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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 closinosetruetitlein.com
City.State,and ZIP Code Telephone Number E-mail
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Seller 1-Name as appears on conveyance document Seller 2-Na >a appears on cony. •nc:document
3961 N KUNKFLI ANE 3961 N KI INKFI 1 ANE
Address(Number and Street) Address(Number and Street)
PATOKA INDIANA 47666 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 comple required byyII and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller i /✓ Si at re of Seller /�
MICHAFL F 1 FISTNFR 09/ /7 /2017 MEGAN P LEISTNFR gyp, bell 09/ I I /2017
Printed Name of Seller Sian Date(MM/DD/YYYI'I Printed Name of Seller Sian Date(MM/DO/YYYYI
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BUYER(S)7,,GRAN TEE(SAPPEICATION TORPROPERTUAX.DEDUCTIONS_2IDENTIEY:AEDITEMSTHATrA6$CY,` -_ - _.__
KEITH M. MAY SYLEST T. MAY
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
3961 N.KUNKEL LANE, 3961 N.KUNKEL LANE,
Address(Number and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY DE USED TO APPLY FOR CERTAIN DEDUCr10NS FOR THIS PROPERTY. IDENTIFY ALL OF TH T T PLY.
YES NO CONDITION I YES NO CONDITION
Z ❑ 1.Will this property be the buyer's primary 17 ❑ 3.Homestead SEP .19 7017
residence? Provide complete address of primary El 4.Solar Energy Hearn/Cooling System
residence,including county:
❑ IN S.Wind Power De ' e .
3961 N KUNKEL I ANE
/
Address(Number and Street) ❑ 6.
,Geo[he IBI EOnergy Aea[ AUDITOR
PATOKA, eANA 47666 GIBBON
City State Zl Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 171 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(Numbe r and Street) a6- os-a0 -300- ooa. 3D2-o18
KEITH M.&SYLEST T.MAY
City.State ZIP Code County
Primary property owner contact name E-mail