Homestead_Vantlin (2) I- INDIANA-SALES DISCLOSURE FORM SDF ID: Page 2
Rexanne McCauley Title&Escrow Processing
Preparer of theSales Disclosure Form Title
3930 Mezzanine Drive, Ste C Columbia Title, Inc.
Address(Number and Street) Company
Lafayette, IN 47905
' E::SELLER(S)/GRANTOR(S).. :; '
Eugene K Windell
Seller 1-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
Y675 1)Av15 h 'L L hb N w
&ress(Number and Street) Address(Number and Street)
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(CS;State,and ZIP rod-e'l City,State,and ZIP Code
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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".
Sig+mt_sz eller_---4 Signature ofSelkr
Eugene K Windell 07//IQ/2 c• 9
Printed Name ofSeller Sirs -ti(ll/OD/YYn)---- , Printed Name of Seller J '�Sign Date(NM(DD/rrn)
F.B - FOR PROPERTY TAX DEDUCTIONS=IDENTIFY tF Y ' j
r nda D.Van lin f/k/a Brenda D.Wm II D
Buyer 2-Name as appears on veyance documen
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rAddres(Nrimber and Set) Address(Number and Street) el R
1rt5i/ ' f:7T ''I I,u zJ7e7C ,41 NU O
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E-mail Telephone Number E-mail
('TTHESALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO• , '. IDENTIFY ALL 0 1 I -T APPLY.
YE.
-,� NO---CONDITION r--- YES NO fANDITION
L`1 ❑'17Wilitliis property be the buyer's primary e ❑ l3 Homestead
residence? Provide complete address of primary g E• ` I, o ar nergy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
I 1
Addresr(Number and Street)--1 ❑ [- 6.Hydroelectric Power Device
a /Yiflt'Px( t.( l tkJe Pi-VitkT f E'V 19tJl- ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Cade I County I 1
❑ N/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 la ❑ 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.
Addres(Number and Street) "�-�t�-/2./g:/ " �0• 3/J O2 7
City,State ZIP Code CountyJ"!)
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".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
Number License/ID/Other Number