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Homestead_Wethington (3) INDIANA SALES DISCLOSURE FORM SDF ID: Pai 'PREPARERi. -_ -- — --- —, Kandace Rogers Closer Prepare:of the Sales Disclosure Form Tale 3101 N. Green River Road Suite 130 Columbia Title Address(Number and Street) Company Evansville, IN 47715 812-471-8563 kandace@columbiatitleoroup.com City State,and ZIP Code Telephone Number E-mail FE S-EGLER(SWGRi1\�TQR(V' Matthew L Wethington Seller I-Name os appears on conveyance document Seller 2-Name as appears on conveyance document 121 North Jackson Street Address(Number and Street) Address(Number and Street) Oakland City IN 47660 E-mail 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�cg/�plet as required by law and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". j'//all.ur .1 Gl/' !n-I Signature of Seller / Signature of Seller Matthew L Wethington 9/20/2018 Printed Name of Seller Sian Date(MM/DO/YM) Printed Name of Seller Sian Date(MM/DD/YYYY) F.f!BUII ER(S')%G124\'rTEES) A'PPLIC•ATrION FOR§( RQF ER7i1JTAXyI)EDIJCTIQNS_,IDE\jTIFY_,ALL'(ITEti9$ZTHATepPP.LIS Alexis L.Wethington Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance doe en 5857 East 115 South1-4 Address(Number and Street) Address(Number and Street) Francisco, 47649 of . k a IDENTIFY ALL OF THOS YES NO CONDITION I YES No CONDITION U1, Y 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead 90O/ residence? Provide complete address of primary ❑ ❑✓ 4.Solar Energy Heating/Coolir9 ystem residence,including count': 5857 East 115 South ID0 5.Wind Power Device Address(Number and Street) ❑ z 6. Hydroelectric Power Device Francisco, IN 47649 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ Kj 2. Does the buyer have a homestead in Indiana to be ❑ Li 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Ilj 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) 07d— /3—/I 1300- Oa/a as/_ oG City,State ZIP Code County Primay property owner contact name E-mail Number License/ID/Other Number