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Homestead_Mathis
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 9D7HREP•ARERr_s . _'a ,.:`s" "V• ,: Il'r _ -r- ;? —r' .s ' LANA C. HARPER CLOSER Preparer of the Sdies Disclosure Form Tide 5231 Oak Grove Rd.. Ste. A - TOTAL TITLE SERVICES. LLC Address(Number and Street) Com poor EVANSVILLE. IN 47715 812-468-8485 City State and ZIP Code Telephone Number E-mail E SELIIER(Sj%GRANTUR(W „--c '"" . --,7r . < . _ — - J°nnifer N I oosrh Seller i-Name as appears on conveyance document Seller?-Name as appears on conveyance document SG 2a E (600/) 1 tss(,\'umber and Street) Address(Number and Street) fr' / c, (I� y7�6G 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 aliand 1 plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". _ / / . ,A cvature of. Iler (' Signature of Seller IAnnifor N nasch /0/i 7/PD / R Printe.l4•",: ,c.ne, Sion Date IM.!/nD/117)) Printed Name of Seller F1 Sian Date lbu/D0/IYnI `.f,BUYER(SW.GR:ANffi SILTARP,EIG1TIONIFORIP,ROPERThNell(•DEDUCTIQNSEID NIFIEYTALL�l � 1' 9;tn�._�i Jaime Mathis n, E+u•'e.i " rmveyarl( doe c Buyer 2 Name as appears on convey..,•d ...(.`.... �dp'n3i(Number and Strict) v) -C�J Addrns(Number and Street) Ot,T 1 t) iOjg Yf n• L w E-until Telephone Number TY AUDITOR E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP' ' OSE THAT APPLY. YES NO CONDITION NO CONDITION ❑ I.Will this property be the buyer's primary I I❑ 3. Homestead residence? Provide complete address of primary U © -+.so ar Energy Heating/Cooling System residence, including county: ❑ ❑✓ 5.Wind Power Device Address(Number and Street) ❑ Z 6. Hydroelectric Power Device ❑ VI 7.Geothermal Energy Heating/Cooling Device City,Staten Code County ID2.Does the buyer have a homestead in Indiana to be El ID B.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ [f 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) Cite State DP Cod, County46-1�_ o_o _ 002 •63\ 02-8 • Primacy property owner contact name E-mail Number License/ID/Other Number