Homestead_Jackson INDIANASALES DISCLOSURE FORM SDFID: Page 2
iD`1P.REP.ARERr ` --
..o.- a _- -,._ _-.__'_".- _
Jennifer Wade Closer
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville,IN 47715 (812)759-5555 closinesretregionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
Secretary of Housing and Urban
Seller I-Name as appears on conveyance document Seller I-Name as ap
pears on conveyance document
40 Marietta Drive
Address(Number and Smell) Address(Number and Street)
.Atlanta,MI 30303
Mate.
and L•C Lode
✓//�.`{
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 complete a _ • b v,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". -
Signature of Seller Signature of Seller
\emessyaTate S .d 1;rZ$.I8
Printed Name of Seller As HUMDt,s,gnated/�oa�Sign Dote(MM/oo,ow) Printed Name of Seller Dap u u'n
EFSBU}.ER(S)'(GRANTEE(S)`�AP.P.LIGATION)EORiPROPERTiS'tT:1XtDEDUCTtONS:IDENTIFYIALLrITEMS�.THATi I) i= _ ID __
Jon Jackson �L1 888
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears an conveyance document
422NBarkerAve SEP 27 2018
Address'(Number and Sweet) Address(Number and Street)
Evansville, IN 47712 n/
E-m d Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES AO CONDITION I YES NO CONDITION
E- ' ❑ 1.Will this property be the buyer's primary V0 3.Homestead
residence? Provide complete address of primary ❑ p 4.Solar Energy Heating/Cooling System
residence,including county: ❑
8061E 300 South 0 S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Oakland City,IN 47660 Gibson ❑ 0 / 7.Geothermal Energy Heating/Cooling Device
Ciry,y'tate ZIP Code County 8.
u ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 9.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ o would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
ind din county: below.Please see instructions for more information.
1 I'' ��1i1 Not available
I/nilnlIall counties.) r YYll
G A'[dnes�(aNumberarid±..eel MIA
1 -'t ''1 1/(� ����,I ''1I'n'III �6n c\Jackson
— Zg ^ �V l - pot . Goo-0Vki
�ItI(UASV(lk.c I V 14 I I l- V U..Y W '!� /i
City,State ZIP Code County] Primary property owner contact name E-mail
V
Number License/ID/Other Number