Homestead_Burr LX
s Ovt,ES DISCLOSURE FORM SDF ID: Page 2
- RER�< c:3�a� f r X3i a ait3`' sr yet x ....0"cw 3
--z- wa Closer
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (
-.n.. E�.�sF-F2C'II �GLSIn>ael asp-5+7-ti-- Vr—Mt '.L .' n s,„:ez i-J- .
Leigh Ann Davis
Seller 1-Name as appears on conveyance document Seller I-Name as appears on conveyance document
901 E Baseline Road,Villa 922
Address(Number and Street) Address(Number and Street)
Evansville, IN 47725
scare,amnv/wee ,
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 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signs re of Der /� Signature of Seller
Lei Ann Davis �.9/03 �'�/7
Printed Name of Seller Sign Date( M/DD/YYYY) Printed Name of Seller Sign Dote(MM/DD/Yrrq
F BUYBR(Slr/GRaNtralsiTTAPEl31CAT10N EORsPROPERTYttTAXiDEDUCTIONSabITO IFY'A Ritiv SATHAT APRLY -ki'1.R:crlts
Scott A.Burr Tandy Y. Burr
Buyer I-Name as appears on conveyance document 8
9621 W 5755 Buyer Name as a PPears on conveyance document
9621 W 5755
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. FILED
Y ES NO CONDITION
WEl 1 NO CONDITION i' 1 JJLILJ
.Will this property be the buyer's primary ❑ 3. Homestead May 08 2019
residence? Provide complete address of primary ❑ p 4.Solar Energy Heating/Coo —
residence,including county: ❑ Power Device
p 5.Wind
6639 W Stonebead Drive GIBSON COUNTY AUDITOR CB
Address(Number and Street) ❑ 21 6. Hydroelectric Power Device
Owensville,IN 47665 Gibson ❑ El 7.Geothermal Energy Heating/Cooling Device
Cdi,State ZIP Code County ❑ p 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 property via e-mail?(Provide contact information
complete address of residence being vacated,
including county: below. Please see instructions for more information.
b2/ 144 h 75 5 Not available in all counties)
Addrpn(h'umberay Street) 26-17-01-400-004. 116-021
(}w?41 i I(ie) X,/y y'7 &6 ' 4:1)59 A Scott A. Burr Tandy Y. Burr
City,State ZIP Code County Primary property owner contact name E-mail