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- SALES DISCLOSURE FORM. . , SDF ID: Page 2
'RERI m` z .'.d3;.et I a',.' r•; (
ade Closer
the Sales Disclosure Form Title le Crest Blvd Ste 201 Regional Title Services
umber and Street) Company - - -
le;IN 47715 - (812)759-5555 closings @regionaltitlellcom and ZIP Code Telephone Number - • . - E-mail
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Donald E. Hawk - ' Melissa CHadk-
Seller 1-Name as appears on conveyance document Seller I-Name as appears on conveyance document
6398 W Stalheim Ave 6398 W Stalheim Ave
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665 •
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a co plete as r uired by w,an is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller - ,, , Signature ofSeller• Ii - .. • '
Donald E. Hawk 0(ee2<77zO/e, 'Melissa L. Hawk j do/ Zp/�
Printed Name of Seller Sign e(NM/DD/YYri) Printed Name of Seller Sign Date(.M/DD/Ynn)
P ri;o, ER(S)`/,GRA t" S1 AP.PLI C ATIONtFORPROP.ERTo1'aTA"X4DEDUGT:(ONS' IDENTFIF.t kliLIT+ITENiSvTHr1T P-Plit •s
James P. Pegram Kelly L. Pegram
peeeson conveyance document Buyer 2-Name as appears on conveyance document
r7q/3 J, AA,/DEE La//
Address Number and Street) Address(Number and Street)
PC/ f [BJ e izc/ , _LE (/71;�/g' -
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P•I• • . . HOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
-$- ❑ 1.Will this property be the buyer's primary •• • 3.Homestead
residence? Provide complete address of primary ❑ E 4.Solar Energy Heating/Cooling System
residence,including county: ❑ E 5.Wind Power Device •
6398 W Stalheim Ave.
Address(Number and Street) ❑ E 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device
City,State ZIP e County ❑ llg, 8. Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ E 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.
Not available in all counties.) —
Address(Numberand5treet) ze — l l —3 l—30 o-001.1 . 6�6
James P. Pegram Kelly L. Pegram O2k ,
Ciry,State ZIP Code County -Primary property owner contact name E-mail