Homestead_McCarty INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
2D:;P,REPARER r ' .-'" =- a y,c =` : _ a te
Lana Harper Closer
Preparer of the Soles Disclosure Form Tide
5231 Oak Grove Road Ste A Total Title Services. LLC
Address(Number and Street) Company
Evansville. Indiana 47715 1-812-468-8485
City,State,and ZIP Code Telephone Number E-mail
cEr;SEliLER(S)''/,GRANTDR(S ; PIC - _ 1-':W . _ - i r f=n_ T - :— `�-7- 7-
Robert Heavrin Victoria Heavrin
Seller as appears on conveyance document Seller 2-Name as appears on conveyance document
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A es�Yumbe-and5tree[) ���� A . baron S
Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a�ndrspm�e as r��by law,and is prepared in accordanceWáC
�"Re I op�less Disclosure Act".
gmature of e15 lv A.
f1 ' 1
Robert Heavrin - Victoria Heavrin I D—2—la ,
Printed Name of Seller Sian Date 1M04/Da/Ylvf1 Printed Name of Seller Sian Date IMM/DD,YMI
GF,3UYERS 'GR y;TjEES T t , ; n - -=� --O/. O�APRLICATIONEOR;P;ROEERT±Y�TA�XIDED.IJCTtONS ;IDE\TIFY.ALli-{ITEir1S'THi�T?�gP,P Y'''r'''''}}}}� �« = :
Gury T.I- MName
McCarty
Buyer l�Nameas apy rsan convey ce document, / Buyer 2-,Vane at appears on conveyance document
A (Numbe'''] and Street) _ �^ )� .. Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS
},PRROPER Y. ID CONDITION OF THOSE THAT APPLY. L.0/, .
YES NO ' CONDITION
0 L] 1.Will this property be the buyer's primary 0 ❑ 3.Homestead un \/T
residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System OR •
residence,including county:
❑ ❑,/ 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP ode County
❑ L 2.Does the buyer have a homestead in Indiana to be ❑ 2 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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 SL-eet)
City,State ZIP Code County ,Z—/o?- of-go I uoar.5•65 01CP
Primary property owner contact name E-mail