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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