HomeMy WebLinkAboutHomestead_West (6) INDIANASALES DISCLOSURE FORM SDF ID: Page 2
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Deena Hendrickson Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (
City,State,and ZIP Code Telephone Number E-mail
Cory J. Fougnies
Seller I-Name as appears an conveyance document Seller l-Name as op.-• son conveyance document
1386 E Taftown Rd 1386 E Ta . vn Rd
Address(Number and Street) Address mber and Street) g
Unde penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belie .: . ue,correct
an of k-te aired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property".les!;,-'?{ r .
\JI / \B G�UN�Y UD
gnature of Sell Signature of Seller S-
Cory J. Fougnies
Printed Name of Seller Sign to(MM/ a Printed Name of Seller Sign Date(MM/DD/YYYY)
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THE SAL DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0 S.Wind Power Device
1386 E Taftown Road ❑ 0 6. Hydroelectric Power Device
7andS
47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
de c°°"ty ❑ (�8 Is this property a residential rental property?
.Does the buyer have a homestead in Indiana to be ❑ 0 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
complete address of residence being vacated, property via e-mail?(Provide contact information
iDcludin ou ty: below. Please see instructions for more information.
-192\ `I Not available in all counties.)
dressOfl
(Number1a•n'S t) aG-{a-os-'loo- 003, 5a3- OW)
1 Warren L. \Vest Jennifer Lynn Campbell
City,State ZIP Code Co r Primary property owner contact name E-mail