Homestead_Powers (4) INDIANA SALES DISCLOSURE FORM SDFID: Paget
tThEfiRE P,'ARER(- , . .—,e -T.'- ter. :Tii.' ti ..47 ._ .. rr--.77 - _y r-77;777,-. :—1
Jennifer Wade Closer - _
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (812)759-5555 closingsrt reeionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
Douglas C. Hughes
Seller I-Name as appears on conveyance document Seller I-Name as appears on conveyance document
{ 1609 Beaver Creek Rd
t
Address(Number and Street) Address(Number and Street) -
Mitchell, IN 47462
•nde I e ties of per' reby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co
•�i as requir•• v,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
A
_,l ever 4 - Signature of Seller
Douglas . Hughes
Printed Name of Seller Sign I�(.I M/D' N.I Printed Name of Seller Sign Date(HAt/DD/YYYY)
1)AIMICI ER VIG—RarlIiEEMY AP.PL`TCATIOMEdfitHROI:ERTOW AX41501T TI0NS131DENTIFLYM Milli ScTiiitarAllii0 7171 '3r1
Terrance Levi Powers Cynthia B Powers
Buyer)-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1 ,
1412 W Broadway St 1412 W Broadway St
Address(Number and Street) ••ress `um•- an• treat
Princeton, IN 47670 Princeton, IN 47670
THE SA DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAI'A2'
NO CONDITION YES NO CONDITION �^/rl. Si
41
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead �O;r
residence? Provide complete address of primary ❑ El 4.Solar Energy Heating/Cooling Sysikt
residence,including county: ❑ El 5.Wind Power Device
10426E 350 S
Address(Number dStreet) ❑ El 6.Hydroelectric Power Device
Oakland C , IN 47660 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device
City,State z code County ❑ 2/ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ El 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail?(Provide contact information
complete address of residence being vacated, below.Please see instructions for more information.
including county:
/J/ p Not available,in all counties.)) ',t G/
Address(Number and Street) opt -�..1-,0tt� - Q - 000- .72' / --0Q`°
Terrance Levi Powers
city,State ZIP Code County Primary property owner contact name - E-mail