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Homestead_Robertson INDIANA SALES DISCLOSURE FORM SOF ID: Page 2 D.PREPARER Stacey Salzman Closer Preparer of the Soles Disclosure Farm Tale - ' 2301 N Burkhardt Rd First Advantoe Title • . Address(Number and Street) -- Company Evansville. IN 47715 812-490-8485 theteamf&firstadvantaoetitle.com City,State,and ZIP Code Telephone Number E-mail I E.SELLF.R(S)JGRANTOR(51 Carlos Firlanglal CnrpOEalinn a_D=aware Com mm:ion Sege-liarerr op ars nn conveyance der . en t k , Seller 2-Nome as apprun on conveyance document '%4ddrrss(I/umber and d St ee) Addrers(NumberandStreet) 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 Jaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". (ro all& V\-cdi ,crio Signature of Seller Sinnature o)Seller Chanel) Wilson 9 -,),6\--IA- Printed Name at Seller Sinn Date VOl/DEVYI'11 Printed Name of Seller Sign Date ru:v:nArrll :BUYERS ',GRANTEE( '4F !CATION FOR PROPERTY TAX DEB CTIONS-IDENTIFY_ LL IT 3,,IS T AT-APPLY-ii 1 lan airlC d • '!!<alnit__ a 1► Buyer I-N Inc as oppea. conveyance dorumeritQ I, I ,uyerr 1-Nomea^sop�rs on conveyance document s. es (Number and,S'trect) Address(Number and Street) THE SALES DISCLOSURE FORM MAY SE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION g" ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead FILED . residence? Provide c mplete address of primary ❑ R 4.Solar Energy Heating/Cooling System r I enc I GI dins ❑ NOV 2 2017 . , r' � � UY _ 5.Wind Power Device I ■ st•Number and•neet r -1(,-, / ❑ 6.Hydroelectric Power Device II I. - a "O1© `L Oi\ ❑ j 7.Geothermal Energy He@51tre/C Ice Cu)-,Stole ZIP Code County ,�c;,ia I is ❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property�ii6aJf7;„�� r pr4pG�y}rjR vacated for this residence? If yes,provide ❑ 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(Manioc,and Street) (//(��yNJ' �/�/ •/�/ City,State yip cane Camrp. a49-!_I-15-a0b -003.T39- 1 Primary vary property own rr contort none Eiauil ,-