HomeMy WebLinkAboutHomestead_Adams INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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•D)PREPARER'i,'._ i� e._ 'LflT _ :.n1 lr�_ ._' . .. :._>".'i'_ _'_ . _ ?G . tr..+.d *.'i.%.
LANA C. HARPER CLOSER
Preparer of the Sales Disclosure Form Title
5231 Oak Grove Rd.. Ste.A TOTAL TITLE SERVICES, LLC
Address(Number and Street) Company
EVANSVILLE, IN 47715
E-mail
EESELLER(S)/GRANTOR(Sji.' _, .23.....:(L _F 'IL?. —.. -y".i:P ' •tki i�._a.:.4' >tt•.r _ . -?!.:'1- '__. ..-
Donald I ee Phillips Barbara Phillips
Seller I-Name as appears on conveyance document Seller 2-Nome as appears on conveyance document
165N. a4 u II S + , � /
Address(Number and Street) Address(Numb; nd5tree /�j
I-4 Au 4 s 1 q d + f n . Lt7639 �/) l `�
correct
an omplete as req ed y law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
gnature of Seller Signature of Seller
flonald I ee Phillips /p !—I+ — 6( C1 Barbara Phillips -_ ei- 6 , q
Printed Name of Seller Sian Date(M.M/DD/YYYY) Printed Name of Seller Sian Date(MM/DO/YTl1
.F..1311XER(SI GRANTEE(S3-APPLICATIONIFORPROPERTY;TAX.DEDUCTIONSr IDENTIFY/ALE ITEMS:THAT APPLY... _. , .
Christopher F.Adams
Buyer A' m ass a rsanc nveya acumen r ' Buyer 2-Name as appears on mnFcfoc eat E T
Addr s Number and Street) _ s{��/n� Address(Number and Street)
'
�11���sL'I I(t �� t` SEP 1 0 2019
City
E-mail Telephone Number ( .„lEt E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROP 'Pt- NTIFYA I ( rl'Y AUDITOR
it-,
NO CONDITION ES NO CONDITION
IL\❑ 1.Will this property be the buyer's primary ►� ❑ 3.Homestead
residence? Provide complete address of primary filimig 4.Suleil Euu a mg/Cooling System
r 9de ce,including nty:
62� iv, to-es L �� ❑ ❑✓ 5.Wind Power Device
Addre��(A mbeLands er) '1 _ q /G���0 ❑ g 6.Hydroelectric Power Device
t or 1 .ra AC t1 1 ,- T O ❑ g 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ g 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ Z 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: . easesee�ins ucHa more information.
Not available in all counties.)
Address(Number and Street)
-IR-13 -403 — oo0 ,6h--026
City,State ZIP Code County '
Prima erty owner contact name -mail
Number License/ID/Other Number