Homestead_Wesselman INDIANA SALES DISCLOSURE FORM SEW ID: Page 2
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LANA C. HARPER CLOSER
['reamer of the Sales Disclosure Farm f 11th,
5231 Oak Grove Rd.. Ste_A TOTAL TITLE SERVICES. LLC
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-468-8485
Cit. State.and ZIP Code Telephone Number Email
LE."S Ei;I:g k OA RA N't.01)t 1:_,-.•...,:t n.,:.±:ins-:i. :r:t'4:-:'. -7.:ni:2-I:.?4:•"-;PI?ti4If".:2:r2T-i:..r12:;12::;:i.;'n1 .;?',117.:.; ;K,t''''''ricri :.'::' '7:.';' E
Pamela J Harmon
Seller I-Name as appears on conveyance document Seller 2-Name as appears on convermcc document
3,214 W , V\h 1 imxt-_ nei-
Th. Wumber and Street) Address(Number and Street)
+lel n t i {-Dr) ■Tk 1 4Ripio
Telephone Number 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 cm )lete as required b ,law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
i
_fatartf.".-e: , LW/ , a
Signature trf Seiler / *nature al Seller
Pamela J Harmon
Iirinted Name of Seller Sian Date(AIM DO/Inn Printed Name a Seller • Sian Date f1431/01) 'Si n
71: BUYER(SyGRANTEE(S)Z.APPLICATION;FORP,RORERV:TAXIDEDUKI0 NSL'iMENTI F,VAtilinTEMS!I ii Min l',FalYiErSAVa!aV
Jeremy L.Wesselman Kayla L.Wesselman
Hover I'Name as appears on contictunce dot omen! Boyer 2-Nome as appear on conveyance document
_53 0 S 1 5 MfisMC241— SiWeeli A _
md„,:5(Number and Street) r
It t
YES NO ONDITION
El 1.Will this property be the buyer's primary • 3. Homestead JUL 23 2018
residence? Provide complete address of primary D 121 4.Solar Energy heating/Cooling System
residence,including county: Lictr----
D NI 5.Wind Power Device)040:cyl
AddrecN(Number and Street) n IA 6. IlydroelectriGIMS014XXIMONTY AUDITOR
j 17j 7.Geothermal Energy Heating/Cooling Device
City.Mate Ai
Z'i de Cuunt-r
n a 8.1s this property a residential rental property?
D U 2. Does the buyer have a homestead in Indiana to he
vacated for this residence? If yes,provide n g 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)
1 -ion- u■01/44 . co° . LIS---7-02-.
(„:„,State ZIP Code County
Primary property owner contact name E-rma!
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
1