Homestead_Durham INDIANASALESDISCLOSUREFORM SDFID: Paget
ttapREPARER-" „.; -_ _ °-'?'+>- r>--• �, -^7_ —mow
Stacey Brown Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and St reel) Company
Evansville, IN 47715 (812)759-5555 closines(threeionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
Brandy NancyEllen Dickenson
Seger 1-Name as appears on conveyance document Seller 1-Name as ap on conveyance document
2933 Bailey Lane 2933 Bailey ne .
Address(Number and Street) Address(Nu r and Street)
Evansville, IN 47725 Evans le, IN 47725
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".
StgnamCOalic" -7�D Slgnoture of Seller �'9
�Brarid� Nanc E11enrDlcl:e son 0� �/ /� �—q
Printed Name of Seller Sly to(MM/DD/YYYn Printed Name of Seller g 'L S.s2?Ue(MM/DD/YYYY)
.413 ERGSI/GRAM1xFEEGS ISAP.PLiGATIONIFORIPROPEEVRI AXiDEDU0E10NS IDENTIF1iAPINTEMS6TiHATMP.PLY - - n° --�` 4-
Billie J. Durham JUL 0 6 2018 S
No-ocn"•ta Jveyance document Buyer 2-Name as a-,••n on conveyance document
416 Ivy Lane 416 Ivy L.•-
Address(Number and Street) •••ress 'u reran• treet NU • --fj -1
Owensville, IN 47665 Owe : ille, IN 47665 GIBSON COUNTY AUDITOR
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS ERTY. IDENTI THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
vo1.Will this property be the buyer's primary ❑ 3.Homeste
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
0 5.Wind Power Device
416 Ivy Lane ❑ 0 6.Hydroelectric Power Device
Address(Number and Street)
Owensville, IN 47665 Gibson ❑ 0 /7.Geothermal Energy Heating/Cooling Device
City,State •code County ❑ ru( 8.1s this property a residential rental property?
^ fd
IF 2. Does the buyer have a homestead in Indiana to be
~ vacated for this residence? If yes,provide ❑ El 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
ncluding county: below.Please see instructions for more information.
Not available in{all counties.) !
Address(Number and Street) 2b—17—01 — 4 QS O C•O. BLI-on_.
Billie J. Durham
City,State ZIP Code County Primary property owner contact name E-mail