Homestead_Hale (8) V
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
SD?PREPARERT.0 *-;ate Jr..:. gCti:.G . _; ,. __;;4, ---,:f",t-t *Z:__-c'?"s . c A=.3:� •?„•a
s- '11}414autiterexm, CLOSER
rrep te,y.,•.............uare 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 7JP Code Telephone Number E-mail
KE EMER(S GRANTOR(" r-><y„3:_f: 'ry 'r" ''.:, 4:ev-,n`r.e3= =,e_a'? n ` a 't?. ::;;CT raK'.- 7
- Jeremy Edrington
Seller I-Name as apoears on conveyance document Seller?-Name as appears on conveyance document
-s
• A05 S. V\In1k� _ + I
Arss(Nu r and Street) Address(Number and Street)
Under penalties of perjury' •reby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and . plet- . - • it• .,; aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
gnature or -11er Signature of Seller
.-rell 0 .e. .I 1.2-21-11
Printed Name of Seller Sian Date(MM/D0/YYYY) Printed Name of Seller
f Sian Date(MM/DD/MY)
RIU,YERSNlR UEES2APP IGATION"FORPROPEafriya \XDEDUCTION iiDENi fiIFEYFALIF,IlkEMSTH'AT'ATPPLY
i ( If. 11 ( �)6—d s } . r i � '� I r x .-af�•..rbtie
Sharon Hale • -
Buye I-Name as appears on conveyance d ronvcyance document Buyer 2-Name as appears on c evance document
Aeifrresss(Number and Street)`�Street) �
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDE,l I/N'pALLQV 10S$THAT APPLY.
1•ES 0 CONDITION YES NO CO.1$IT(dfjIV� ep
�❑ 1.Will this property be the buyer's primary 3.Homestead V�-tV q I
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Coo-11(k System
residence,including county: ❑ Q S.Wind Power Device
Address(Number and Street) ❑ 151 6.Hydroelectric Power Device
❑ NI 7.Geothermal Energy Heating/Cooling Device
City,Stale ZIP de County
❑ 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 ❑ IN 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)
Z (0— is —i F'-Za30oi. X05oa
City,State ZIP Code County
Primary property owner contact name E-mail