Homestead_Chitwood (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
CHRISTINA LENFERS CLOSING AGENT
Prepares of the Sales Disclosure Form Title
501 MAIN ST STE 101 BOSSE TITLE CO
Address(Number and Street) Company
EVANSVILLE IN 47708
E-mail
E.SELLER(S)/GRANTOR(S)
i I
JEANNE M MCCONNEI L
Seller 1-Namegs appears on conveyance documen Seller 2-Name as appears on conveyance document
j aa-'1 E 01,o0
Address(Num aand Street) 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 complete as required by law,and is prepay d ' accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
..M l, Mc ori, V 5-22.41:19
g reofSeller Signature of Seller
IFA F M MCCONNFI L 0502/2019
Printed Name of Seller Sign Date(MM/DD/YYTY) Printed Name of Seller Sign Date(MM/DD/YYn)
F c . ' R(S)/GRANTlE(S3-APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL ITEMS THAT APPLY
ADAM G CHITWOOD ALICIA J CHITWOOD
Buy-r1-Name as a eyonce document Buyer 2-Name as appears an conveyance document F
I LED
' 43 GIBSON ST SAME
Address(Number and Street) Address(Number and Street)
OAKLAND CITY IN 47660 Jun 1n, 3 ?019—
City,State,and ZIP Code City,Stoic and ZIP Code
liOt
E-mail Telephone Number GIBSON COUNTY AUDITOf.-pal
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR T'PROP.BRTi'-1DEY7t THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
kg ❑ 1.Will this property be the buyer's primary Er ❑ 3.Homestead
residence? Provide complete address of primary eating/Cooling System
67 ( Ssidencj cludl g_ 5�1ty: CL ❑ 12/�J �/L tr —r� L.J�r/n S.Wind Power Device
Addrar(Na )d G J.1`e `C L &0 0 6.Hydroelectric PowerCoolin Device g
7.Geothermal EnergyHeatin Device
City,State ZIF2ode
Sil ❑ Et/ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 0 R' 9.Would you like to receive tax statements for this
complete address of residence being vacated, propertyvia-e-matt? Provide contact information
including county: below.Please see instruction ore information.
Not available in all counties)
Address(Number and Street) 26-14-19-102-001. 051-007
City,State ZIP Code Coun
Primary property E-mail