HomeMy WebLinkAboutHomestead_Clark (7) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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LANA C. HARPER CLOSER
Prepererof the Soles Disclosure Form Title
5231 Oak Grove Rd., Ste-A TOTAL TITLE SERVICES, LLC
Address(Number and.Street) Company
EVANSVILLE. IN 47715 812-468-8485
City,State,and ZIP Code Telephone Number E-mail
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Seller 1-Name as appears on nvncedocu:nen[
7 Igo Seller 2-Name as appears on conveyance document
A(/' • (Number and Street) Address(Number and Street)
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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 prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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wture of Seller Signature of Seller
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r;ant ilr- 5-AD - Ii .
Printed Name of Seller Sian Date Dta/OD/Y1f1 Printed Name of Seller Sian Date(MM/DU/ITYII
F UUYER S7GRANiMEES) .APP6r(EATION FOR PR'OFERT�I)liUCsDGDUCTIONsffalDEOFyl A14PdT,EMSti' ' . i";,C 1'h - -;'s- " '
Kath n Clark `sI, I•
' a n conveyance document Buyer 2-Name as appears on conveyance document
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Address(Number and Sheet) Addr's(Number a d .7 ,
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,.:'.elate,and ZIPS de City.state.
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY roil CERTAIN DEDUCTIONS FOR T 11 PROPERTY. IDENTIFY ALL OE THOSE THAT APPLY.
YES O CONDITION 'FS •'0 CONDITION
r ❑ 1.Will this property be the buyer's primary r ❑ 3.Homestead
residence? Provide complete address of primary I/ inch imuer'g 'eating/Cooling System
residence,including county:
❑ TA 5.Wind Power Device
Addres(Number and Street) ❑ [f 6.Hydroelectric Power Device
• ❑ 0 7.Geothermal Energy Heating/Cooling Device
• City, to ZIP Code County
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❑ 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 ❑ IA 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
below. Please see instructions information.
for more in
inc mg county: cc f
83D tf cS
7S , Not available in all counties.)
AdUWeleKit t)ij.{ rhk 471,45 * 26-17 - 09-200-0oL .6ID -02I .
Cif.;State ZIP Code Count_
Primary property owner contact name 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 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 fled.)
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u4 ate/ t (i.• `)CAIY JC_.
Signature of Buyer] r� Signature of Buyer? pause
Scott Alan Clark 5-.c &_.\ % Kathryn Clark 5 a 2 +- IP
License/ID/Other Number Number License/ID/Other Number