Homestead_Ott (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2018 Page 2
D. PREPARER
Teresa S. Holifield Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 teresa @swinland.com
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Rachel S. Kell
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
•
• 196 E 780 S
Address(Number and Street) Address(Number and Street)
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and co lete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
71.I
' Signature of Seller ✓ Signature of Seller
Rachel S. Kell 3/20/2018 3/20/2018
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MMIDD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT j,LY -'
Jeramie R. Ott Candi L. Ott ,��
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance docum
7849 S Andee Lane 7849 S Andee Lane 'LJ,9,p •
Address(Number and Street) Address(Number and Stree,'4ie 2 -
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THiTHAT APPLY.
YES NO CONDITION YES NO CONDITION /,‘.
0
0 ❑ 1. Will this property be the buyers primary 0 ❑ 3. Homestead "P
residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System
residence, including county:
❑ 0 5. Wind Power Device
196E780S
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Fort Bra ch, IN 47648 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
City,St ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like-to receive tax statements for this
vacated for this residence? If yes,provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below Please see instructions for more information.
Not available in all counties.) -
Address(Number and Street)
Z. 6-/9-i9-ao3 -rn I. z.310-oa y/Q
City,State ZIP Code County Primary property owner contact name E-mail