Homestead_Hinton INDIANA SALES DISCLOSURE FORM SDF ID: Page Z
'D.PREPARER - - - •• - - _
Dana Belcher Processor
Preparer of the Sales Disclosure Form Title
2301 N. Burkhardt Road-- First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 (
E-mail
E.SECLFR(S)/GRANTOR(S) - .-_ __ _ - -
Jessica I Flpers
Seller I-Name us appears on conveyance document Seller 2-Name as appears an conveyance document
Adc111 )4r\Att1hW\S 120
Address(Number and Street) Address(Number and Street)
L h nA,t{t -r'N t-1-i t, tcj
am State.and ZIP(Jade City,State,and ZIP Code
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".
to A leC(2Qe,�) FILE
Signature of Seller Signature of Seller
Jessica L Boers h l? II y
Printed Name afSeller Sion Date(MMD//DYYYT) Printed Name of Seller $ Ton Date(MM/00/YYY1
F.BUYER(S) GRANTEE(S)-APPLICATION FOR PROPERTY TAX'DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY:;_- _ _ _ A11-2,
Morgan J. Hinton MAY 8 2019
? i�me+P- ryes on cantwancedoc Buyer 2-Name as appears an conveyance document
•
Ad/�s(Nof t randStreet ((// ( / Address(Number and Street)
I /\ �
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLYFOR CERTAIN DEDUCTIONS FOR THIS PROPE TY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I Y ,
❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary 4.Solar Energy Heating/Cooling System
( 1 reence,jpylu0ngFounty: ❑ ❑
( U `_.ryye ✓ 5.Wind Power Device
Add�rNNnm rndStre � (' J 0 o yd ❑ 0 6. Hydroelectric Power Device
, lT'^•l ) ` / �t/ �I - ���11'T� ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
El ElZ.Does the buyer have a homestead in Indiana to be ill 0 8.Is this property a residential rental property?
vacated for this residence? If yes, provide ❑ 2 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.
Not available in all counties.)
Address(Number and Street) .
a 6 - 1 ,3 - 39 - boo -o00. 516 - 00 4
City State ZIP Code County
Pnmary property owner contact name E-mail
Number License/ID/Other Number