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Homestead_Grigsby
IMPIANA'SALES DISCLOSURE FORM SDF ID: Page: LDb$REFARER = - r . • -41-5,W4- . '—.q Deena Hendrickson Closer Leah Brown 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 closines(tl)reeionaltitlellcom City,State,and ZIP Code Telephone Number E-mail __ , � s z- s-,. - i-'..;> _-�z�>�°-.4=1-- :..e .:,.- tc.sa+r,-=.cz?-z i ..--,=' a—‘-.: r'--rrB7-ttA. —c _-R ., Karen S.Adams Seller)-Name as appears on conveyance document Seller]-Name as rs on conveyance document 103 S Haven Dr 103 S Ha • n Dr Address(Number and Street) Address mber and Street) E-mail Under p:. allies of per - ',II hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct a d co •plete as re• .ire+r and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". at-La ��I /(l-c (gnat re ofSeller j �T� Signature of Seller (/O- Kari S. Adams 'rinted Name of Seller Sign Date(MM/DD/YY) Printed Name of Seller Sign Date(MM/DD/YYYY) s 'YER• I.. TEE&WAP:PI CATIONIRORiRRORER••W AXIDEDUCIDI©NSfiIDEN:T;IESSALLSITEM•1I'',1i'fP.L-_ .i'`; //\ Bridget Grigsby _ ;- s1r fuyerI-Name as appears on conveyance document Buyer2-Name as appears on conveyance document 1000 Stanley Ave 1000 Stanley Ave 1 A' It- Address(Numberand Street) Address(Number and Street) JUN I2 j ailk 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 „...}-Er NO CONDITIO' ❑ 1.Will this property be the buyer's primary tg ❑ 3.Homestead residence? Provide complete address of primary • r •. , . - 3' eating/Cooling System residence,including county: ❑ 103 S Haven Drive 0 S.Wind Power Device Address(Number and Street) ❑ 0 6.Hydroelectric Power Device Haubstadt, IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County ❑ /g Is this property a residential rental property? ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 9.Would you like to receive tax statements for this vacated for this residence? If yes,provide complete address of residence being vacated, property via e-mail?(Provide contact information including county: below. Please see instructions for more information. \°c)C) S\a.�\e.-( kc•e Not available in all counties.) tr,�a_p�1 s O Address(Number and Street) 26-13'-36-40 52- 1= ,.,a,NSai1\e `C) `-lA-A\I \, \-,.-_Ae, v,t. e), Bridget Grigsby CI-noo. City,State ZIP Code County Primary property owner contact name E-mail