Homestead_Rembe INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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THOMAS L. MONTGOMERY GENERAL MANAGER
Preparer of the Sales Disclosure Form Title
101 PLAZA EAST BLVD.. STE. 102 TRUE TITLE SERVICE. LLC
Address(Number and Street) Company
EVANSVILLE. IN 47715 812.402.6555 closines@truetitlein.com
City,State,and ZIP Code Telephone Number E-mail
CLAUDIA GARCIA
Seller i-Name as appears an conveyance document Seller I-Name as appears on conveyance docu n I �{
205 W 4th Street 11--,
Iddress(Number and Street) Address(Number and Street)
I SON t- i-rY nllT
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge andnbehef,isP&R &Nett
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller �n Signature of Seller
CLAUDIA GARCIA 7 / W/2018
Printed Name of Seller Sign D°te(14M/DD/YYY1) Printed Name of Seller Sign Date(MM/DD/YYY)
r F. BUtSER(Sl/GRANTEEQSI IAP.P.L'iCATIONiEORcPROPERTNTAXIDEDUETIONS_IDENTIEYiAtiL'ITED1SLTHATdP.P.IY,_
SHANE M. REMBE HEATHER N. REMBE
Buyer I-Name as appears on conve,vnce document Buyer 2-Name as appears on conveyance document
527 Divison Street,Lot 2A 527 Divison Street,Lot 2A
4ddres(Number and Street) Address(Number and Street)
Oakland City,IN 47660 Oakland City,IN 47660
THE SALTS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
Y NO CONDITION
ES N I YES NO CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ E 5.Wind Power Device
342 S. Jackson ST
Address(Numberand Street) ❑ 2 6.Hydroelectric Power Device
Oakland City. IN 47660 Gibson ❑ 0 J.Geothermal Energy Heating/Cooling Device
City,State ZIP ode County ❑ 8. Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ M 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail?(Provide contact information
complete address of residence being vacated, below. Please see instructions for more information.
including county: Not available in all counties.)
Address(A'umberand5tree[) 24_VU-18-Lt03 -000 .O� _col-
SHANE M. REMBE HEATHER N. REMBE
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