Homestead_Vallee INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
,D; 40-A- ER ,f- %St4',.''s a 3 3•E l_.t 7 is'.th I,al 1` .. E°v .-:*.r: 'H it .z- ° ia cilia I _ .:
Christina Latham Title Clerk
Preparer of the Sales Disclosure Form Title
4703 Theatre Drive Regional Land Title
Address(Number and Street) Company
Evansville, IN 47715
E-mail
E.SELGER(s)1GRANTOR(sy.7 TX7 _ _ _. : _-.•_ .__. _ ,... :- _ a ' '-T71: _.
• Joshua M Wickert
Seller I-Nam as a ear on ton once document Seller 2-Name as appears on conveyance document
1 (3/ die
Address(Number and t et) Address(Number and Street)
I
that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
. r omple a as re wired I"y I v,and is prepared in accordance with IC 6-1.1-5.5,"Real Property es D' cl ct".
/
n —/147C/g
[ o Stier Signature of Seller GIBSON COUNTY AUDITOR
.- uaM Wickert /f
'Tinted Acme of celled iqn Dat M.M/DD/rrn) Printed Name of Seller Sian Date(M.a/DD/IYYI)
WITIV)/,GRANTEIT OPT"OW]o clAit•.P,R arenY TAX•,DEDUGTIONSHTI ENTIE AL'L ITMS-THAVAPP-L•Y;_ ______7_ - _
Pamela Kay Vallee4,t,
_ Andrew B. Hastie
Buyer I-Name asa pears on cdo erA r7 s Beyer 2-Name as•a�rs o conv once document
I Il//L/L/— X Lit-,-, I/-fl Am f\J e,n) t
Address(Number a Street) lddrrress(Number and Street)) �/
X GVgr1SVr/Ie I y/V "177It/
Cirr,State,and C e ,City State,and ZIP Code
Telephone A'ioriber Email
CO
YES NO CONDITION ES CONDITION
❑ 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary mg/Cooling System
residence,including county:
105 W Park St ❑ 2S.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Ft. Branch IN,47648 Gibson ❑ 2 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.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 ❑ 2 9.Would you like to receive tax statements for this
complete address of residence being vacated, rty via e-mail?(Prove e ct information
including county: below. Please see instructions for morel motion.
Not avilable in all ties
Address(Number and Street) ( ac; .)s�Y
City,State ZIP Code County ~ 0 property owner contact name E-mail
Under