Homestead_Prater IIfDIANA'SALES DISCLOSURE FORM SDF ID: 2019 Page 2
D. PREPARER
Kristina Watson Escrow Officer
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (
mail
E. SELLER(S)/GRANTOR(S)
Ellis Estates, L.L.C., an Indiana Limited Liability Company
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
7199 Newman Rd.
Address(Number and Street) Address(Number and Street)
Elberfeld, IN 47613
City, State,and ZIP Code City,State, and ZIP Code
Telephone-Number 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 prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Brian Ellis, ao rks /6—`
Printed Name of Seller Sign pate(MM/DD YY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUY �'•NTEE(S)- ATQN FOR PROPERTY X DEDUCTIONS -IDENTIFY ALL ITEMS THAT APPLY
Au Jam Q ookej?rater
:uyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
001 Aces Ln.
Address(Number and Street) Address(Number and Street)
Evansville, IN 47714FILED—
E-mail Telephen T 8019E-mail
THE SALES DISCLOSURE FORM MAY BE U -= 0 APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. ENTIFY ALL OF THOSE THAT APPLY.
S NO CONDITIO. YES NO CONDITION
0 1. Will this property be the buyer's primary )( ❑ 3. Homestea gam)
residence? Provide complete address of primary �4. Sol ergy Hea ng/C-ooliti trni hYnAUDITOR
residence, including county:
2084 E SR 64 E ❑ Wind Power Device
Address(Number and Street) ❑ 6. Hydroelectric Power Device
(Prr....inceton, IN 47670 Gibson ❑ 7. Geothermal Energy Heating/Cooling Device
City,State ZIP Code County 0 8. Is this property a tial rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ' ❑ 9. Would you like to receive tax s a nts for this
vacated for this residence? If yes, provide complete - ct in ation
address of residence being vacated, including county: below. Please see instructions for more n.
Not available in all counties.)
Address(Number and Street)
City, State ZIP Code County Primary property owner contact name E-mail
License/ID/Other Number