Homestead_McCutchen INDIANA SALES DISCLOSURE FORM SDF ID:
Page 2
D PREPARER _ 1 Zz w'saz a . L3y goot' �� rG ay T _ar
DEBBIE JACKSON TYPIST
Preparer of the Sales Disclosure Form Title
530 FREDERICA ST. FOREMAN WATSON LAND TITLE, LLC
Address(Number and Street) Company
OWENSBORO, KY 42301 270-689-2424 DJACKSON @FW-LT.COM
City,Statt and ZIP rode - Telephone Number E-mail
4eEPSEt2'Ea GRANTOR(S)','ee = 'r*rgrect 1, =. . x. ; m an titre` z_ .l?lgraan. alts t ll .rf`r*'0
JEFFREY S. EVANS
Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
Address(Number and Street) Address(Number and Street)
301
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comp : e as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Si.na.j el r ` Signature of Seller
F /'Yr�S L\/ans a 1a\\\e6
Prix.red Nameo/ eller An Date(XM/DD/YYYYI Printed Nameof5eller Stan Date yy/DDuiTm
11,F;113 11/.• j,- =.•• ._,AP,P,I.IEATiON,fORIP.ROPERTY.TAkDEDUGTION5;°,ADEN.TIF,1',ALLlI'FEMS'xTHAT,APPLa `rn? 3aa
RASOOL K. MCCUTCHEN AARON K. BLAIR-MCCUTCHEN
Buyer I-Name as appears on conveyance document Buyer2-Name as appears on conveyance document
&a� Mac (-& &, ct`C1a in S*
ddress(Number and Street) �ddrress(Numberland Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT IN.
YES NO CoNDm0N I YES NQ CONDITION
® \ 'p 1.Will this property be the buyer's primary ❑ 3.Homestea GIBSO .COU !'fY AUDITOR
residence? Provide complete address of primary ❑ 4. oar nergy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
h. S- ` 6.Hydroelectric Power Device
Address(Number and Street) ❑ ICI. y
ei • It • •S IA A gill Obi ❑ p 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.) 7 9
Address(Number and Street)
a? -/2 -09 - 3 o ('-QDO• 75/ /` - o A e
City Stare ZIP Code County .
Primary property owner contact name E-mail
-