Homestead_Seibert INDIANA SALES DISCLOSURE FORM SDF ID: Paget
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EDs_PREPARER .. _ - -
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Stacy Brown Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (812)759-5555 closinesno regionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
Brock S.Conner Kendra S. Conner
Seller l-Name as appears on conveyvn acumen Seller I-Name as appears on co veyancegg�ment
3°h F . LInA \) • ,3i)Y F - co
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1AQ1�dress( umber and Str et) `\' /�f l�l�l n /mil dress((N bera dStre t)y1- T(� `/--(I'/I7/r�\�^
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an m lete as req • efl by law,and is prepared in accordance with
,//IC 6-1.1-5.5," eal Property Sales Disclosure Act".
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Signature of Seller /A7Ji
Si nature o SellerBrock S. Conner Kendra S. Conner &j�ii
P' amen a Sign DOte(MM/00 Panted Name of Seller Si Date MM/'K
EICBUYER(SI7GRANIFEEl i_°APP•LIGA'TIONIEORTP.ROP-ERTYaTAXtiDEDUGT CNS-1DENiTaEVALLRITE lfligiafiliLY[_H ail. i-
Chad Louis Seibert Samantha Nicole Sollman I ' I��iJ-L7
Bo pars an-conveyance document Buyer 2-Name as appears on conveyance document
231E1200S 231E1200S AUG 292018 6
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 3..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: ❑
302 E Elm Street 0 S.Wind Power Device
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Haubstadt, ,'47639 Gibson LI 0 7. Geothermal Energy Heating/Cooling Device
City.State zl rode County ❑ ^ U/Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 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(Number and Street) 26- Ia\ -31-3 -00034I -009
City,State ZIP Code County Primary property owner contact name E-mail