Homestead_Blake INDIANA SALES DISCLOSURE FORM SUP II); Page 2
D.PREPARER
LANA C. HARPER CLOSER
I'n pon'r of Mr Sokc Div hnurc Awn) rich
5231 Oak•Grove Rd.. Ste.A TOTAL TITLE SERVICES, LLC
,WJrns(Number and Street) Capon•
EVANSVILLE. IN 47715 812-468-8485
r'up,c,ute.am!Mr.* I:'Irl,mmr'N„mix" e-mail
c E.SELLER(S)/GRANTORM
Laura I Boyle
4c•lh I.Nam'asuppeon nunmycoon c,,num..nr Seib,2.Nomeu.um,on enmrnaxedurmncnt
04-7 &RWeMlfa DizIVE
rlaw..(Nun m dxn ul Arcrl) dAJnun ado,and Street)
EVHNSVIL.LE HQ 47715 o.p\'
..S•s '1'rphunr Numfm Email _
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
al
tmplete as required by law( s prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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hinted Annie ul.4ifer Shin Dote l M ti/nlrl n'n1 Printed Nome of Seller Sign nine W u/omm,11
F.BUYER(S)%GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPI.Y
Dennis M. Blake pg KIP blynj
I ns Mime or, n nm eh.. nll rvume wn ` buyer Mann.
Nor .uppmn on.om,?an,,,
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—04Ur.-nt i-nb/vi DEC 2 6 2018
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1urcSALES ISCLOSURE FORM MAY BEl15EDTU,tI'I'L11uR CERTAIN DEDUIMONSrim,.usPROPERII' IDENTIFY ALL orrittPIESTAPI OUNTYAUDITOR
ITS NO CONDITION YI's NO CONDITION
LI ❑ I.Will this property be the buyei's primary C 0 3.Homestead
residence? Provide complete address of primary ❑ ❑ •1.Solar Energy Ileating/Cooling System
residence,including county:
❑ ❑✓ 5.Wind Power Device
.led,r•.1Nmrdxr,mdsnmil ❑ El 6. Hydroelectric Power Device
❑ ❑ 7.Geothermal Energy Heating/Cooling Device
city,Stale r Cade ruunrr
El 2.Does the buyer have a homestead in Indian. to be ❑ Q 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ M 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 iRate information.
Not available in all counties.)
AJdrrm(Nu tr and Street)
rrfi•.Srate ZIP Cock County0(0-11-D I - 4D3 -COD 'a 17— odd,
I'rnnarl'prdberlyrnrberrnntnrr name Ednail
Number License/ID/Other Number