Homestead_Michel (15) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
FD.,P,REEARER' _.__ »
THOMASL.MONTGOMERY GENERAL MANAGER
Preparer of the Sales Disclosure Form Title
101 PLAZA EAST BLVD.. STE. 102 TRUE TITLE SERVICE. LLC
Address(Number and Sweet) Company
EVANSVILLE, IN 47715 812.402.6555 closinesnatruetitlein.com
City,State,and ZIP Code Telephone Number E-mail
•
E. JOAN MICHEL SPECIAL NEEDS TRUST
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
1897 E.750 S.
lc/dress(Number and Street) 4ddress(Number and Street)
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
a complete as re uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Si 'nature of Seller Signature of Seller
et E. Gentry, Trustee 01/17/19
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DO/YYYY)
CF�UY DO[IGR�A6E(Slt= J1CATIOt\bFO1ZP.ROPERTtYr�TA�XCDEDUC^TIO<\S'_�IDENT[F.7_ALLeITEMStTHAT�APPL'Y�_ - _,_ "'"_"i
T MICHEL 'T��tlf J�t '9
e 1-Name as appears conveyance d .eat
Telephone Number 4i E-mail
1{S r COUNTY PUnITOR
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPE '-IDENTI Mat TAPPLY.
YES NO CONDITION YES NO CONDITION
I ❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of prima ❑ 0 eating/Cooling System
residence,including county: ❑
1897 E. 750 S 0 5.Wind Power Device
❑ 0 6.Hydroelectric Power Device
Address(Number and Street)
Fort Branch, IN 47648 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device
City,State P Code County ❑ [�8. Is this property a residential rental property?
❑ 2.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 prope -mail?(Provide con rmation
complete address of residence being vacated, otv. Please see instructions for more infor lion.
including county: • Notto
available in all counties.) C
Address(Number and Street) _IQ_2-l— t0 0 ^ op 0 . 712- -Oy
BRANDON C. MICHEL .
City,State ZIP Code County rcontact name E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with
Number License/ID/Other Number