No preview available
Homestead_Sullenger (2) INDIANA SALES DISCLOSURE FORD- SDF ID: Page 2 :DP.REPARER -�....,1,_14.. : '..,»�:.: . . .,. c.a .- �a :1•.... . ... s- ' ._z ea. _tt..- t... .. .F ......, r CHRISTINA LATHAM TITLE CLERK Preparer of the Sales Disclosure Form Title 4703 THEATER DRIVE REGIONAL LAND TITLE Address(Number and Street) Company EVANSVILLE,IN 47715 812-402-4553 CHRISTINA(au)REGIONAL-LT.COM City,State,and ZIP Codes Telephone Number E-mail Mt -SE : �r"^. "rt.�.i.�.teh -t_.+..'T.$ = `-51a 5,1.'[' i"', ." J`.y,K' '; -:ao_1' u;- Nora Susan Schuble Seller 1-Name as ppears on conveyance doc„uwtie.st Seller 2-Name as appears on conveyance document A es-roar6umd.ee11Ls ' Address(Number and Street) 1 V Syj.L/e, -I�/ 7/5 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 an complete as yquired by la -pand ',pre r. .r-din accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". • , % / Si -iThPafSelleri ,, //-t Signature of Seller Nora Susan Schuble _//.�✓/�J. Printed Name of Seller S -d an'Date.IMMlibili T{ Printed Name of Seiler Sian Date(M.M/ooryrrr) (F!;BU,X-ERgy:GRA<\;TEE(,rAP,I;LICQTION,F,GRIP,ROP,ERT,YbTAX,I)ED.UCT,IONSODENTIFiY?riLL�'+,IT,EMS3THATAP,P,GY �K`'-��-== Duane E. Sullenaer Jodi L. Sullenger 3 Buyer 1-Name as a rs on conveyance document Buyer"? Nam so wears nro vevn document 102< ressF�' er and Street) Addr r er it 1I 2, l' , 77n. E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THISPROPERTY..IDEN'nFY'ALL OF THOSE MOAT AP `'v ID list no7mm"-noSz. .YESI -'NO coNDITI ,\ 6bi EL---0 1.Will thl�property be the buyer's primary 171-0 -3.Homes ad `UUN? X — residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling Systeni/ - residence,including county: El O� 5.Wind Power Device 10217 S Quail Crossing Address(Number and Street) ❑ 12 6.Hydroelectric Power Device Haubstadt. IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ oes the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Fl 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.) p Address(Number and Street) 0 - /1- .Z/,Jou_ coot o so - t—'v Victoria R.Dawson City,State ZIP Code County Primary property owner contact name E-mail