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Homestead_Horning INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 LIXPLRER--T - ------- -- -------_--.T—_ Roman Ricker Attorney Preparer of the Sales Disclosure Form Title 219 N. Hart St.. P.O. Box 13 Partenheimer, Kinkle 8 Ricker Address(Number and Street) Company Princeton, IN 47670 I 812-386-0050 rricker(a)hpk-law.com City,State,and ZIP Code ' Telephone Number E-mail ill SEL`LER(S)%GRAN.TOR(S)i-_- ;. � , - Dennis R Raider Karen S Raider Seller I'Name as appears on conveyance document Seller 2-Name as appears on conveyance document 377E 750 S 377E 750 S Address(Number and Street) Address(Number and Street) Fort Branch IN 47648 Fort Branch IN 47648 City, Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an4j-eemplete as re uiFei-N lay+;a dred-in-accordance with C.6 Property $disclosure ' " Signature of Seller Signature of Seller Dennis R Raider • 3/812019 Karen S Raider by Dennis Ray Raider POA 3/8/2019 Printed Nam Sian Date(MM/DO/YYYI) Printed Name of Seller Sign Date(M)4/00/YYYY( LP? _ R(S)% RAN,TEE(S)`_ PFLICATIONIFOR;$RQPERTYiTAXi:f)f)EDUGTIONSIDENTIEYL'L'dTEMSTTHATF•AP,PGYt - Dawn Marie Homing - Buyer an conveyance document Buyer 2-Name as appears on canveya_FILE. 1217 Richland Avenue Address(Number and Street) Address(Number and Street) Evansville, IN 47711_._ MAR 11 2019 City,State ndZIPCode City,State,and ZIP Code --I- E-mail Telephone Number '�s.�.yl,(�p4, �' ;; E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY IDENTIFY ALL OIGIB9ri(w } .... AUDITOR ' YES NO CONDITION ccONDITI0N 0 ❑ 1.Will this property be the buyers primary 3.Homestearesidence? Provide complete address of primary • rgy eating/Cooling System residence,including county: 377E 750 S 0 05.Wind Power Device Address(Number and Street) 0 IZI 6.Hydroelectric Power Device Fort Branch. IN 47648 Gibson ❑ E 7.Geothermal Energy Heating/Cooling Device CBI.;State ZIP Code County ❑✓ El2.Does the buyer have a homestead in Indiana to be ❑ ❑� 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ 17 9.Would you like to receive tax statements for this complete address of residence being vacated, pr a-coal . ntoct information including county: . Please see instructions for mor ' rmation. 1217 Richland Avenue Not available in all counties. Address(N'umberand Street) 6 -0 1' 'below Ir - 02Jr---Evansville, IN 47711 Vanderburgh oming City,State ZIP Code County Primary property owner contact name &mail Number License/1D/Other Number