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Homestead_Hume (3)
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 James H Shelton Preparerofthe Sala Disclosure Form Title In• Officer Title 3495 US Hwy 441 Address(Number and Street) Baird Home Cor oration Company Fruitland Park, FL 34731 City, andZlPCode 352-787-2500 isheltonebairdcorp.com Telephone Number E-mail • irgaltaOrlalI?fj FifSfak � .r-e :f 'f�roaaMM- a r: " ' G, S:'..i °,n Ronald W Houchins - - -- Seller I-Name as appears on conveyance document I lSlle 2-Name as 1p5 t Seller 2-Name as appears on conveyance document 4840E 200 S Address(Number and Street) 4840E 200 S Address(Number and Street) - and co lete as required by law,and is prepared in accordance with IC 6.1.1-5.5, "Real Property Sales Disclosure Act". 474 ET�i�s---co / 7y Slgnaw eofSeller c-'J--.Lf.L4 o�/am/ Wa�C��/1`u_ Signature of Seller Ronald W Houchms - - 11/30/2017 Printed Name of Seller - J ucretia Nome alS ns 11/30/2017 gait Date(MM/OD/YYYf1 Printed Nome o Seller Sign Date itiat ER(S)'/:Cs-RA`i�'IL h'(S) AAPtilidi liORIMANIP RTiY X0 1 7 2 15114 4 Otv'ME ilia-ALffE E ZRATttAEPLYalz =^: � 7 t Timothy J. Hume - - - --- - Byer1-Nameasappears ancanveyancedocument • Jo E. Hume Buyer 2-Name as appears on conveyance document 1301 W Morton St 1301 W Morton St Address(Number and Street) - Address(Number and Street) �; YES NO CONDITION YES NO CONDITION `/f��l,,, ' 2 ❑ 1.Will this property be the buyer's primary 7�^ '" residence? Provide complete address of primary 0 ❑ 3.Homestead GIBSON COUNTY P.UDITOR residence,including county: ❑ © 4.Solar Energy Heating/Cooling System 1301 W Morton St ❑ 0 5.Wind Power Device Address(Number and Street) Oakland, IN 46975 ❑ Z 6.Hydroelectric Power Device City,State ZIPCode Gibson Coun y ❑ 7.Geothermal Energy Heating/Cooling Device ❑ Q 2.Does the buyer have a homestead in Indiana to be ❑ WI 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ VI 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.P/ease see instructions for more information. Not available in all counties.) Address(Number and Street) ,n/ // t���/'� City,State ZIP Code County l y� II.au-l0O-(oDINn3-DD&