Homestead_Danels _INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - _. _ _ -
- Kim Loesch 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
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S�%GRANTOR(S) _
•
.
Rick E Smith I eqe M Smith
Seller I-Nome as appears on conveyance document Seller 2-Name as appears on conveyance document
X 1 0 c l-11' l—a-nve x io9 4-) i- Lof- C
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure, -1 he best of m knowledge and belief,is true,correct
and couple as required by law,and is prepared in accordance wit ee-1.1-5.5,"R 1 Property Sales Disclosure Act'.
/�• k • ' 1! /
Signature ofSeller Signature of Seller
Rick E Smith )c lb-Z7-/7 Leslie M Smith ; :♦ ur a./
Printed Nameo Seller Sian Date(M34/DEVITI ) Printed Name a Seller j rBliSM 12110 Yn
F..BUYER(S)/GRANTEE(S)-APPLICATION.FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM ; H JL pjy' i0' ' _
eremy K'Jailers-) Devin R Danels OV �. 2017
er1-N appears on conve a docu eat Buyer 2-Nome as appears on nveyancedocume
110 5 . s� i .,
Addr ( umber antreetj (ye Address(Num. ands/ / 4 in
THE SALES DIS OSURE FORM MAY RE USED TOAPI'LY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES CONDITION . r
❑ i.Will this property be the buyer's primary a ❑ 3. Homestead
residence? Provide complete address of primary --ra---7 -rSoTar Energy Heating/Cooling System
es .e e, ndNdina un ❑
�( rl jar y po/r1ty S.Wind Power Device
Address(Num.. ,/d{treeq cI V:e L7(P70 ❑ Q 6. Hydroelectric Power Device
t t n(e v) l �!V t•t"/ ❑ Q 7. Geothermal Energy Heating/Cooling Device
City State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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) u
City, ZIP County °2 {° ' /l ` i / - boo -00.0.5)24 -0 a 7
Primary property owner contact name E-mail