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Homestead_Rivera INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Lynette Murray Processor Preparer of the Sales Disclosure Form Title 2301 N Burkhardt Rd First Advantage Title Address(Number and Street) Company Evansville, IN 47715 812-490-8485 theteam(a�firstadvantagetitle.com City;State,and ZIP Code Telephone Number E-mail j E.SELLEl2 S)/GRANTORjS)r a 3.r ' 1 inda L Hauhold Seller l-Name sap rs on conveyance document Seller 2-Name as appears on conveyance document 363 \ Address(Number and Street) Address(Number and Street) "P( ( , v N el76970 City,State, Telephone Number E-mail Telephone Number E-mail Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as required by law,and is I repared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". ignamre of eller Signature o%Seller I inda I Hatthold by Melinda K Prerts7 AIF 5-30-/ Printed Names Seller Sian Dote(MM DD/YYYYI Printed Name o Seller F.:BUYERSrGRANTEES -APPLICATIONOR':PROPERTYTAXDEDUCTIONS- IDENTIFY-ALLITEMS inapoa mit Ines M Vigoreaux isappears on conveyance document Buyer 2-Name as appears on conveyance document .. 3)S w. Se(u(Q_ 5-F , �� YUN 07 2018 dress(Number and Stre t) Address(Number and Street) (,n(e-t-On 1 N H7(970 /,,;.. • � Telephone Number E-mail Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CQNoITION V ❑ I.Will this property be the buyer's primary ❑ 3. Homestea residence? Provide complete address of primary �1 IL 4.So ar Energy Heating/Cooling System residence,including county: 3 )t— 60 5 ry-u t. ❑ 5.Wind Power Device 44tess(Number and Streeq ID SI 6. Hydroelectric Power Device 1)(VW/-EO(M7 � M k7(197b ��04050I\ ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP ode County 2. Does the buyer have a homestead in Indiana to be ❑ $ 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) ‘, -/& — o7-/od - DO0k. X76-0018 city State ZIP Code County Primary property owner contact name Einuil Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". (Note: Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is being filed. Signature nj Bi9'rr l Signature of Buyer2/$rouse Edwin Rivera OS 30 (2018 Jnes M Viporeaux �/3 0 /70 la •