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INDIANA SALES DISCLOSURE FORM SDF ID: . Page 2
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Lynette Murray Processor
Preparer of the Sales Disclosure Form Title
2301 N Burkhardt Rd First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 812-490-8485 theteamefirstadvantagetitle.com
City,State,and ZIP Code Telephone Number E-mail
cOg It ERISPGRAN TO RiSr-L-5421:7;r 7,112;-;;TE7.5:1W-LF-1175.--,;:tt....arerH r:T:Vie..FP;D.;73,1...f-"r:TW .
Harold A Owens
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
'-/3/i &off!m Aid
Address(Number and Street) Address(Number and Street)
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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 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
Harold A Owens by Harold S Owens POA /07/7 Pd/7
Printed Name of Seller Sian DateWM/DB/Mtn Printed Name of Seller Sion Date(SISVOlyrnY)
4:43-UYER(WGRANTERSIkt,APPOCATIONJE014ROP.ERTY1fAX1DED.U.E.TIONS:VII/ENTIENVALLTITEIci-S;THAVA—PV ?."717:77-7777:7 T
John H Block JR Lisa Block l
Buyer I-Name as appears on conveyance document r i Buyer 2-Name as appears on conveyance document
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Address(Nutt carCA- d %- - a d Street) Address(Number and Street)
Cat110 Crt 1 1/4 \k 0 Or/
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY/t-
-
YES NO CONDITION I YES NO CONDITION '1/5,3
n 1.Will this property be the buyer's primary cg, Ill 3. Homestead -to
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residence? Provide complete address of primary 0 g 4.Solar Energy Heating/Cooling System •
residence,including county:
-° I a --AA1\-1/4 1.-ck v\-Q0 0 S.Wind Power Device
Address Csnad Street) . . I
‘c-.S 1 Q M.9..._. -Si.) 4--)lsk..k-s-- 0 7] 6.Hydroelectric Power Device
D IL 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
O INI 8.1s this property a residential rental property?
111 lal-N2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 0 2 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)
OZ-1 2--0/- t t C J- CCO .44g- 60-701
City,State ZIP Code County
Primary property owner contact name E-mail