Homestead_Hase INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.EREPARER _ 1 + .r z1:7A-727.; L. x g.r f ,• ice: <c:: n'I
Kim Loesch Processor
Preparer of the Soles Disclosure Form Title
2301 N Burkhardt Rd First Advantage Title
Address(Number and Street) Company
Evansville,IN 47715 (812)490-8485
City,State,and ZIP Code Telephone Number E-mail
t_._ T__ 'I ,r t.i ski• . ;' ,J .�`. t .-;spa :_— "'a Z. •s '" •,0 5751
LE:SEL'LER(S�/GRAn,TOR(S)v�' ��;;�. � „ ., _ �'.'< � r�xs::F� 7 r'�-1:��..
Griffin A Robbins
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
sqz Li Gitndak Sir _
Address(Number and Street) Address(Number and Street)
Pr:i•cei- n ,tN 47(270
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 c9mpl a as cored by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
SSiignaa . fSeller /9r p� Signature of Seller
Griffin A Robbins `Ali
Printed Name of Seller Sian Date(MM/DD/IYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
,Z g :, ,ER }fG_RLA TEE(SjISAPPL'-IGATIONEEOR_,RORERTIYtTAX4DEDUCTIONS�IIDENTIFeWAL EI' A;7 YyR •. i . •
I Paul J Hase - ._1 L! i
Buy e eanyn comicroarer nce docume Buyer 2-Name as appears on conveyance document
c 2 &. I�/af er -' � SEP 1 1 2018
Ad dr�.a umber and Street) Address(Number and Street)
-INS/ Ce 1/1 C% 70
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PR RitYrtISENTWeALL. THOSE THAT APPLY.
YES 0 CONDITION YES NO CONDITION
E LJ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary 4. Solar Energy Heating/Cooling System
r sl nc t ludin couynty:
7 oiPnf a./� ❑ ❑✓ 5.Wind Power Device
Address( brandStree) __ // ❑ 6. Hydroelectric Power Device
/ / /SCE �• L� 1 7�7(] ❑ ❑ 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ B. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ l 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) n n
City,State ZIP Cade County
;, /c- I9,yV6- 34�3-CODiligl-oak
Primary property owner contact name E-mail
Number License/ID/Other Number