Homestead_Myers INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER ; - . .
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402 4553 CHRISTINA(@REGIONAL-LT.COM
City,State and ZIP Code Telephone Number E-mail
-E.'SELLER(S)/GRANTOR(S):' . - _. _. )_ . _ . .- - - .
' Phillip W Lundeen
Seller I•Name as appears on conveyance document Seller 2-Name as appears on conveyance document
`,(\_ gddress(Number and Street) Address(Number and Street)
CO;State and ZIP Code Ciry,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and 7'complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
P,BUYER(S)/GRANTEE(S)=APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL`ITE t PIr;
Jamie S Myers
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance darn"++"r •
Xlc-13, E Consec �l' 4,0n 1\C
Address(Number and Street) '�/I -7!''� Address(Number and Street)
xt\( Inc� n , SrVl •
THE SAL 1SCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THA Y. 'x
�C"f 1 7 /Oil
YES NO CONDITION I YES NO CONDITION
El 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ Fl 4.Solar Ene�ytled* tem
residence,including county: ❑ UNT`9AUDITOR
5.Wind Power Device
7314 S Division St
Address(Number an Street) ❑ 12 6.Hydroelectric Power Device
Oakland City 47660 Gibson ❑ NI 7.Geothermal Energy Heating/Cooling Device
Ci)t,State ZIP a County
ig
❑ 2.Does the buyer have a homestead in Indiana to be Ill 8.Is this property a residential rental property?
vacated for this residence? If yes,provide n ID 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)
Ow,StateVPCode Counry (Q 6 -a D-1 q- 3 0.3-o00. D/glinsit
Primary property owner contact name E-mail