Homestead_Wojciechowski INDIANA SALES DISCLOSURE FORM SDF ID:
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. REPARER ._2.Vitt' _.
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Lynette Murray Processor
Preparer of the Sales Disclosure Form Title
2301 N Burkhardt Rd First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715
EE,SEC$.ER(S)%GRAN.T.OR(S)} raj t -•r _ ._ -- 352,1. I ::1:7 it 1 !!re -( o .,
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Barbara Jean Wallace
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1a re 6rc--C-e.—d ej—
Addkess(Numbr and Stree Address(Number and Street)
C/v-- -�-&K, ( �QL.t . (27 7 I?-
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 completeL as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller (UU/ p �1 Signature of Seller
Barbara Jean Wallace Sian � 0 I D/—
PantedNameaf3cHer— _ Date(xtv/UYYn] Printed Name afSeller Sign Date(HAI/Do/Tm)
•Fi:BBIW.E:14S)'/G ONTEE(1 .Ak:ICATION FOR-.PROPERTY_TAX',DEDUCTIONS`` IDENTIEYAECITEMSTHATAP_.BLt__ 7 ; _ J
Amanda M Nam Woi e owski F S LE D
uyer -Na asap ears
[URIC ronve• a cur Buyer 2-Name as appears on convey da m
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Addr (ur erp C 11eh es / 2^��/ Address(Number and Street)
City,State,
Email T umber E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FO IS PROPERTY. IDENTIFV•ALL OF7t]I�SA d}NTY AUDITOR
r YES 0 CONDITION I YES NO CONDITION
❑ I.Will this property be the buyer's primary J ❑ 3. Homestead
residence? Provide complete address of primal ' ❑M 4. Solar gy eating/Cooling System
a/ /I ;esiderySe)iuclZlcjing °lint':
W W(r(,C 11 g- c`I-, IJ and over Device
Addre / umber and Str et) p f (//7 ❑ ID 6.Hydroelectric Power Device
f Once Street)
' L' " 7 6 )a ❑ ❑ 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
ID ID2. Does the buyer have a homestead in Indiana to be ❑ El 8 Is this property a residential rental property?
vacated for this residence? If yes, provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, r y via e-mail? ro ntact information
including county: / below. Please see instructions for ma a nmtion.
Not available in all counties.)
Address(Number and Street)
StaleZIPCo e County _Z 6 — \?--cl -k02-'001 -AgC\ —02b'.
City rimary property owner contact name E-mail ,
Number License/ID/Other Number