Homestead_Bird INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - - -
1
Deena Hendrickson Closing Services
Preparer of the Soles Disclosure Form Title
7820 Eagle Crest Blvd., Suite 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 deena.hendrickson(ohregionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
_J.amesj Short _ Simine Short
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1691 E Autumn Ridge same
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 ct mplete as required bylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
. S .,-e S -P4. 0 .
ature of Seller / Signature of Seller
• / -
leer
u e,L y /li Zd/,� Simine Short - K0` -
Printed Name ofSeller Sian Date(MM/OD/YYYY) Printed Name of Seller ( �( te(M.M/DD/YYYI)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY-TAX DEDUCTIONS •IDENTIFY ALL t t '�• - _ .
usan R Bird
. as appears on conveyance document Buyer 2-Name as appears an conveyanceficsbjenl 8 2018
239 Oak Ave
Address(Number and Street) Address(Number and Street) `'nI[
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITION----
❑ 1.Will this property be the buyer's primary Z ❑ 3.Homestead
residence? Provide complete address of primary ❑ L1) 4.Solar Energy Heating/Cooling System
1I /� esidence,including county: ❑
u Vll { $\1\'uY n 'crc 5.Wind Power Device
)i- t ess, \5n2berand{treet) Tnq �� GI\N ❑ z 6.Hydroelectric Power Device
j� l�1VtJ'J�C i' ,� VJL/1 ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP a 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 ❑ 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.)
Address(Number and sweet) g - A3 " / 4 — aoO• too o - (i 86 -Oay
City,State ZIP Code County
Primary property owner contact name E-mail