Homestead_Day ..3 • .
' INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D�t.PREPEZRE0• u . . -. _ . ,-, - s
Kandace Rogers Closer
Preparer of the Sales Disclosure Form Title
3101 N. Green River Road Suite 130 Columbia Title
Address(Nen her and Street) Company
Evansville. IN 47715 812-471-8563 kandacetacolumbiatitlegroup.com
City,State,mod DP Code Telephone Number E-mail
1 L E U S E L L E.R.G R Z A N I T O R ) ;-"' ,t - -; -,;o -•.. • , :'..r. _ ,. , I
Abigail M<rkley Collin Strader
Seller]-Nc-i as a pears on cove nce document r Nameasa pears on com'emnce document
gq5 rirki .'Ong r �{ ' IC�r �A1d �v-
Address(Numberan Street) Address(Number
:=
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an compll i re5tu d y law,and is prepared in accordance with I 6-1.1-5.5,"' +al Property Sales Disclosure Act".
Signature of le: Sign lure of Se er G
Abigail Merkley 5 -to "14, Collin Strader - 5 ' 10•\ ,
Printed Name of Seger Sian Date(M.N/DD/YYYI) Printed Name of Seller Sign Date(MM/Da/YYYY)
PRAYIER(S)ILGRANBEE(S) 'APP.LI CATIIOi1;EORPROIWRTTY6TiatDED EIT:lONS DENiTIIFYt A,LLilTEMSr$H!4TijrMPr$LW1 S' c"'• ;- '?
Ryan J. Day
Buyerl-Nameasoppears on conveyance document Buyer 2-Name as appears on conveyan•'d. ,nt1
2363 East 750 South .--
Address(Number and Street) Address(Number and Street)
Fort Branch. IN 47648
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF T
aY168 N COUNTY AUDITOR
• YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0
2363 East 750 South S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
IN
❑ E Y 2.Does the buyer have a homestead in Indiana to be ❑ 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) I ./h �I,�/
City,State ZIP Code aC.— R - d\-i uV - oo ° �- b _ O15
County
Primary property owner contact name E-mail