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Homestead_Elliott (4)
INDIANA SALES DISCLOSURE FORM SDF ID: 2018 Page 2 D. PREPARER • Kathy Masterson 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 kathy©swinland.com City,State,and ZIP Code Telephone Number • E-mail E. SELLER(S)/GRANTOR(S) Nicole L. Meny Seller I -Name as appears on conveyance document Seller 2-Name as appears on conveyance document 10004 S Quail Crossing Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 . Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and as ls required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". 'Signature of Seller Signature of Seller Nicole L. Meny -Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL ITEMS THAT AP Christopher S. Elliott Ashley R. Elliott -1 I Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1330 Bowden 1330 Bowden Q P • Address(Number and Street) - • Address(Number and Street) )� 11201R Evansville, IN 47725 Evansville, THES'DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. Lr IOR YES NO CONDITION YES ENO CONDITION ❑ 1. Will this property be the buyer's primary lay ❑ 3. Homestead residence? Provide complete address of primary ❑ 0;4. Solar Energy Heating/Cooling System residence,including county: 10004 S Quail Crossing ❑ 5. Wind Power Device Address(Number and Street) ❑ /0--f 6. Hydroelectric Power Device Haubstadt: IN 47639 I Gibson ❑ -CJ 7. Geothermal Energy Heating/Cooling Device • Cii)vState ZIP Code County ❑ Z 8. Is this property a residential rental property? V° ❑ 2. Does the buyer have a homestead in Indiana to be ❑ p' 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. 3� /� ow et Not available in all counties.) Cl. Address(Number and and Street) I 00a/.454°- 6a T tn(S� \�Q Ih� `� S �// ' 0710 �� 3G -,'ao Cif,State Z Code County Primary property owner contact name E-mail