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Homestead_Kleaving
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 7:1__SK -lam F� Vim. 3 7 Jeff Dodson Closing Agent Preparer of the Sales Disclosure Form Title 1911 Lincoln Ave Clear Title Company Address(Number and Street) Company Evansville, IN 47714 812-423-8854 City,State and ZIP Code Telephone Number E-muil EzSELilIER SS Zia ANTOR S '�' 2 yrcrilt xs �r_r-�— 'e1. --.�s-W T >•, �� t ) LU.,i ..' Y'eeti."r� `'Y' .. 1 ia�N l�.'i'4.Yfff'L�_ I✓� Z}^i=uiry' ��.,'..• Gy fax Family Homes I LC Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document / Y721 f)¢ri.-.r to tot /2..c%. Address(Number and Street) Address(Number and Street) •-/ e r 1tt' 77 and corn e as re uir by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". /Yt e r ,gnature of Seller to/ Signature of Seller / Printed Name of Seller ✓ Sian Date(MM/PD/19YY) I Printed Name of Seller Sr Date(NM/DD/MY) INF R(S GRWRifiEE(S UTRET T10\)fi0R±f':RCI RTcYIdTAXiDEDUG:FI°N 'II DENIBIF,VINTL,l STET MSpTHANAP_,P,Li.:3, '5intt4 Adam R Kleavinn Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document • 305 E Foster St Address(Number and Street) Address(Number and Street) Fort Branch, IN 47648 YES NO CONDITION YES NO CONDITION • (7] ❑ 1.Will this property be the buyer's primary ❑ 3.Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 305 E Foster Si ❑ Fi S.Wind Power Device Address(Number and Street) ❑ L 6.Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ E 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Q 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 ❑ 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) City,Smte ZIP Code County a 6- / ?-I 9- x9I- 000- 139-oa Primary property owner contact name E-mail