Homestead_McClanahan (2) G
INDIANA SALES DISCLOSURE FORM SDFID: Page:
I).P,IiEPARERs - 4, 7'
Deena Hendrickson Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (812)759-5555 closings(&u.resionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
Russel Delong
•
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
13 W Red Bank Road 13 W Red Bank Road
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
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
an comp ete as ryiquired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature f5eller -a / rSlgnatureofSeiler
Russel-Delong Z (//�G /Jd 7 \
Printed Name of Seller., Sig Date MM/DD/Yrvnf Printed Name ofSellert Sign Date(M.e/a0/1Y57
( BE BUYERIFSI%GRtASIMEEISl AEP-iifEATI0NIFOARROPERTiY3TARitiEDUaiIONS-
Jfl
CONDITION I YES NO CONDITION \ GIBSON COUNTY AUDITOR
1.Will this property be the buyer's primary 1:Erf 0 3. Homestead)
residence? Provide complete address of primary - ❑ p 4.Solar Energy Heating/Cooling System
residence,including county: i
El 5.Wind Power Device
13 W Red Bank Road
Address(Number and Street) ❑ Q 6-Hydroelectric Power Device iFo Branch, IN 47648 ': Gibson ❑ ^El 7.Geothermal Energy Heating/Cooling Device
CI ,Sm[eZIPcode County ❑ LH"/R Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 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
� n/\I1 including county: below.Please see instructions for more information.
WU"l S l_i-iCo\{1 Not
available/ �J in all counties.) J
(A,ad�ress u`� r�and'Street) (� ' l_ �-,ga,gi�jaaa�I —OZ' L
y• rat
wv�ijA t. I i L(1 U L(i G(YI c�\ _Andrew McClanahan Tom L. Wallace
uy,State ZIP Code - County Primary property owner contact name E-mail
Hi-amp/IO/usher Number Number License/ID/Other Number
