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Homestead_Walker (3) • . INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 -. . . . _. D:PREPARER: - . LANA C. HARPER CLOSER Preparer of the Sales Disclosure Form Title 5231 Oak Grove Rd., Ste.A TOTAL TITLE SERVICES, LLC Address(Number and Street) Company EVANSVILLE. IN 47715 812-468-8485 City,State,and ZIP Code Telephone Number E-mail E:SELLER(S)/GRANTOR(S) . -_ . Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document Address(Number and Street) Address(Number and Street) City,State,and ZIP Code City.State,and ZIP Code Telephone Number E-mail 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 and complete as required by law,and is prepared in accordance with IC 6-1.1.5.S,"Real Property Sales Disclosure Act". Signature of Seller Signature of Seller Printed Name of Seller Sian Date(M..V/DD/YITY) Printed Name of Seller Sian Date(MH/DD/YITY) F:BUYER(S)/GRANTEE(S)'-.APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL'ITEMS THAT APPLY_ _ -. ', re efir(Sfi kb)kr�r a��h �/ I� Buye Name as pears oncog7nce omen! q/ Buyer 2-Name ni P`on conveyance document 44//���,� Ad s(Num ran Street(/'1(f S� / '{� Addresyss((Nuu�jmerand Street) Ltry;Smfe, PN9 YES NO CONDITION d I YE NO CONDITION '(y ❑ 1.Will this property be the buyer's primary ] ❑ 3.Homestead GO residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/CooeSystem residence,including county: ❑ 0 5.Wind Power Device G' Address(Number and Street) ❑ 0 6.Hydroelectric Power Device ❑ 0 7.Geothermal Energy Heating/Cooling Device City tate TIP Code County El2.Does the buyer have a homestead in Indiana to be ❑ 0 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. WO OR S/ t/ ' kiwi K� Not available in all counties.) A d ess(Nu berandStree•I —v ,!^ ECcu�i cry— J/J_VI (/L0 5 AG-1°‘-3,.-ioo-oo . 11 g-3,.. -i City,State ZIP Cade 1 County Primary property owner contact name Email