Homestead_Genco INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D?_PEPARER: T ,—ao --- -- 13,.- .= is -. — ---'._ _ C----?I'. '77. _ ,f -_i--__---7 3•-
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Jeff Dodson Closing Agent
Preparer of the Sales Disclosure Form Title
1911 Lincoln Ave Clear Title Company
Address(Number and Street) Company
Evansville, IN 47714 812-423-8854
City,State,and ZIP Cade Telephone Number E-mail
E:,SEL'bER(SJ/GRA(E0R(S) -- ._•s
Adam D Brothers
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
ISIeo Clover SE
Address(Number and Street) Address(Number and Street)
Mount ..tsncrl, ? W y763
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comp -to as required b aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
7,.aim Ftsue/
ignature o f Seller Signature of Seller
AGiai✓( P. 6 roEh &I- S '
hinted Name of Seller 5 Sign Date(MM/00/YYYY) Printed Name of Seller Sian Date(MM/Do/rml
;F.>BUYIER(S)/,GRAN TEE(S)—APP LIGATION.FOR:PROP,ERTYJ A_
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. AUK/TAR
YES NO CONDITION YES NO CONDITION
TA ❑ 1.Will this property be the buyer's primary P ❑ 3.Homestead
residence? Provide complete address of primary ❑ IN 4.Solar Energy Heating/Cooling System
residence,including county:
527 E Water St ❑ VA S.Wind Power Device
Address(Number and Street) ❑ 21 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ E 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
0 ❑ 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 ❑ El 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.
6052 S August Main St Not available in all counties.)
Address(Number and Street)
Winslow, IN 47598 Crkv^ Z10 -1a - 07--IO1 00R.5)7-o0R3
City.State ZIP Code County
Primary property owner contact name E-mail