Homestead_Vantlin INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
kD:P.REPARER_? e� �_.:cr rt Y;_ . ',- nt: _"C • v a _ , i .sc , „::;;W:=44-t.,
_ 4m fJorre zn •CLOSER
Preparer of the Sales Disclosure Form Title
5231 Oak Grove Rd..Ste.A TOTAL TITLE SERVICES, LLC
Address(Number and Street) Company
EVANSVILLE, IN 47715 • 812-468-8485
City State,and ZIPCode Telephone Number
E-mail
E$EI LE-R(S yatANTO R[,� ./ e - • - _:, ,S:
..d ..:` - -L3::.-• F .,. .. _ _ .
Michael S Gayso Marcia K Gayso
Seller I-Name a ppears an ,nveya a-ment , � Seller 2-Name as appears on conYyance document
/ a /
a . ss(Number and Street) A
dd—e • r an reet)
(Inc
Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comple • a ir• nd is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
*�_,�-tea I a A S
Signature o Seller Signature ofSeller (�
14. I•• -C9 ID -I 0-11 MarciaK Gayso I D -111-1
Printed Name of Seller _ Sian Date IMM/DU/YY Printed Name of Seller Sign Date(MII/DD/115Yi
F;,BUYER[S) GRANTEE(S)'LAPP,LIGATIONFOR,PROP6RT:Y_TAXDEDUCR,IONS`IDENTIEYiALL'ITEMS;Tt1ATA Ii.PLS, e . . -
Jacob A.Vantlin Y
Buyer l-Name as appears an sweyance document Buyer 2-Name as appears an corncyanc m r[T FD
u t N . ,t,c s--r. , •1 ,
o7I s(Number and Street) Address(Number and Street)
thnLP *Cr 70c4 41 Lt7U OCT 1 8 2017
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF TN V 1[J3a 1vi3nu NYY AUDITOR
YES 0 CONDITION❑ 1.Wilt this property be the buyer's primary YES NO CONDITION
�❑ 3. Homestead
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0 S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 5 7.Geothermal Energy Heating/Cooling Device
City. .ate ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide n IN 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.
�d U`
W , Y1 -Q I nu't St• Not available in all counties.)
a(Number and Stret)
MtnCy? 17) n , ci,,, 1 )1,- to aG - Ia-o2- 1o,-woa•o?3jP
City.State ZIPCode County
Primary property owner contact name E-mail