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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -
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Kim Loesch Processor
Preparer of the Soles Disclosure Form Title
2301 N Burkhardt Rd First Advantage Title
Address(Number and Street) Company
Evansville. IN 47715 (812)490-8485
City,Stott and ZIP Code Telephone Number E-mail
1 (E4SEIMBLS_KORIMIMIOR(S); - ` %r. s� — _., -. b.r
Kyle T Chapman
_AntN Merritt
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
i Q&2C IV L-afayhe AVc
IAddress(Number and Street) Address(Number an reel)
F_vansvi llc , I nAcana 917 71 (
•
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and cp`'l1eas required by law,and is prepared in accordance with C 6-1.1-$.S,"Real Pro erty Sales Disclosure Act".
Signal of Seller
not o Seller
Kyle T Chapman y'17—Ig h'�,d /i" 1-m s
Printed Name afSeller Sian Date(MM/DD/YYY11 Printed Name of Seller Sig D (MM/DD/YYYI)
�F.BUYERS GRr1NTEE $• lieWSligg
Thomas S Lashbrook
Buyer l-Name as appea on can cyonce d curve �� Buyer 2-Name as appears on conveyance document
as(1 1ttier� CAXc
Address M mbetr and Street) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.,IDENTIFY ALL s ati OSE APPLY. •we
O
YES NO CONDITION I YES NO CONDITION t5 N V
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead C0441/)-
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Codling System
residente, ' udin county: ' /p
4v / S. 0/� C, . ❑ F S.Wind Power Device O,_
Addr pmbe�ndStreeq� A ICJ4—'�' `C, ❑ 0 6.Hydroelectric Power Device
1L rain i /v "T b ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code / 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 Street)
46-/9-i9-JG3 - cool. o 7 od6
City,State ZIP Cade County
Primary properry owner contact name E-mail