Homestead_Carson (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D,'.PREPARER' a :-,k }t ' :is:.-- .t - _ ;,+'..- :if.- .Y •:s.. - ?+S: _ .- , c it ..
LANA C. HARPER CLOSER
Pre)mrer of the Sales Disclosure Form Title
5231 Oak Grove Rd.. Ste.A TOTAL TITLE SERVICES. LLC
Addr .(Number and Street) Company
EVANSVILLE. IN 4/715
Email
E.SELLER(S)/GRANTOR(S)Lef
t.1v31e :t .'-i 1.4.2,,.L.•95/ t,'- -.;1 _t *:�:;.., : _rr 41x!7)1�.;y :i>3`,_..5. u.-d WW1 "s.
Betty cille Rrackin ANi/-) Be-ri-If 1Grl 8 °' ✓?
S•l -Nam rs on conveyanceentE Seller 2-Name as appears on conveyance document
t Co
dddre.!DrimMr and
oLcr (/� LI_7 fr Address(Number and Street)
City.
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 co req Nred by law, nd i- /repave in accordance with IC 6-1.1-S.S,.,Real Property Sales Disclosure Act".
Signature of Selle V�j/ •• ` Signature at Seller
,,
Betty Lucille Brarkin ` -6A l-[`_19
Printed Name of Seller Sian Date IMM/DD/YYYt) Printed Nome of Seller Sian Date(MM/oa/1»'1l
I. B 7G7iAN I.LEj PPLICATION:FOR,PROPERTaY_TAX.DEDUCTIONS'IDENTIFY'AL l ITEMS"THATrAPPI]'t " ..,:"'
Jeffery A. Carson Cassandra E. Carson
Buyer I-Name ass co ,sore dorum Buyer 2 Name us appears on conveyance dorum nt
Q I
Addr n(Number and,Street) Add. s(iNumber and Str"el i
Cay.
E-mail Telephone . r E-mail
THE SALES DISCLOSURE FORM MAY BF USED TOAPI'LY FOR CERTAIN DEDUCTIONS FOR TII IS PROPE YA TH 4.���
YES CONDITION ,�,/ytr COSDIT109 lltll
G ❑ 1.Will this property be the buyer's primary (� U 3. Homestead
residence? Provide complete address of primary ❑ sting/C System
M
residence, including county: ATi id-t " 2019
❑ 2 S.Wind Power Device
Addres,(Number and Street) ❑ 2 6. hydroelectric Power vice
❑ El 7.Geothermal Energy I- Device
CItE s'tte ZIP Code county GIBSOM rn v
i ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a e Wm1
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-LL�a'I' contact information
including county: 6 . ease see instructions for mo " ormation.
a71 i S. m: 1 ) Not available in all counties.)
Address(Number and Street)
^01— 0 Ya8 —
City.State ZIP Code County
(I Pn'mary property owner contort name.."-------__1 E-mail