Homestead_Heuring (2) •
INDIANA SALES DISCLOSURE FORM SDF ID: Pa:e 2
D.PREPARER - - .' t r .;:" —
LANA C. HARPER 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 ZIP Code Telephone Number
E-mail
E.SELLERS)/GRANTOR(Sj "' t - _
Karen K Richardson Kenneth Wayne Dillon
Seller I-Name as appears an conveyance docOment .` Seller
-- ppears n conveyance document
(D 31.3 i.J. OLD Pe) nce>ton of e �-/7>
Adpress(Number and Street) y 7b bS Address( t:aberand Street) D �
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".
WOAPI\ 9� , A I Cl r`-� `� ��/7 L /t GU2i�rtt N14161), 4z/4--
Signature of Seller ����/� Signature of Seller —1/.. . A /^i (44i4, 4471 nod
Karen K Richardson Karen K. Richardson his attorney-in-fact /O Y' 7
Printed Name o Seller Sian D te(M /DD Printed Name a Seller Si•n Date(MM DO 1)
tl ilm1a__I______. /4 1 •.• • 1 •. '-i DI I 'S`. i 1 ♦ • 1721111Migliflill
Alden J. Heurinq Jill N. i-� _-- ----- t - --
1 . Heurinq - •.
:Myer - one as appears on conveyance document Buyer 2-Name as appears on conveyance document
SAOq [,UC e,c 65-b A/ NOV 3 7017
r (Numbe and Street) Address( ber and,tr' t)/
Pe&rthro /N L/761P7 / 1 •
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
YE
x g ❑ 1.Will this property be the buyer's primary (r X ❑ 3.Homestea
/� \residence? Provide complete address of primary , oar nergy Heating/Cooling System
j�,/ r pce,incty: ❑
(Wj e�� ,, / (,f�F7 0 5.Wind Power Device
Adreyum anreet.0 �� //V #71,4,7 ,`1 . / _ __ _ ❑ 0 6.Hydroelectric Power Device
cig'S reZlPCode J C.l r�County (,'❑ 0 7,Geothermal Energy Heating/Cooling Device
2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
❑ Y
vacated for this residence? If yes,provide ❑ r 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) p
2 _ (8- 13 -goal - 000 . S2 a _p }.,6
City,State ZIP Code County
Primary property owner contact name E-mail