Homestead_Russell (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER •
Pam Hancock title administrator/closer
Preparer of the Sales Disclosure Form Title
221 NW Fifth St Lockvear Title, LLC
Address(Number and Street) Company
Evansville, IN 47708 812-421-8405 pamela(Wlockveartitle.com
City,State,and ZIP Code Telephone Number E-mail
•
E.SELLERS)/GRANTOR(S) .
Michael D. Banister
Seller..//I-�1Name as appears yon conveyance document Seller 2-Name as appears on conveyance document
J Yba W tea-) leo 5/L4-L .
Address(Number and Str eel) –7 Address(Number and Street)
Pdcrcbt rP1 , IN I-1 l5C
Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as re•u—•. w� d ' -prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
-ignature of Seller Signature of Seller
Michael D. Banister I\- 10 -17
Printed Name ofSeller Sian Date(MM/DD/MO Printed Name of Seller g' Sian Date(MM/DD/YYYYI
-F:BU_.,;,,,„,,,.:,...�..Ce—t.'_'_ : ION FOR PROPERTY TAX DEDUCTIONS=IDENTIFY ALL EMIT AT 1'p
Mark Russell and Mena C. Russell, husband and wI - �J!
Buyer 2-Name as appears on conveyance document
60 4 w p;n Knt NOV 14 2017
Address(Number and Street) Y Address(Number and Street)
Prior( ton IN 41610
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES _NO——CONDITION
17 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestea
residence? Provide complete address of primary
residence,including county: ❑ 4.Solar Energy Heating/Cooling System
604 w si nkney ❑ 12 5.Wind Power Device
Address(Number and Street) I ❑ 12 6.Hydroelectric Power Device
pr i n u ton, 1 NI 4/610 6-i 6 Sol ❑ 12 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ Er 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)
.Z4 — /x • 07 - 30.3 - 003. r/3 9-0j-$
Ciry,State ZIP Code County
Primary pro perry owner contact name Email