Homestead_McCarley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
17.PREI?ARER .: ...... , , ,
Dana Belcher Processor
Preparer of the Sales Disclosure Form Title
2301 N. Burkhardt Road First Advantage Title
Address(Number and Street) Company
Evansville, IN 47715 (
E-mail
'E.SELLER(S)/GRANTOR(S) ` `+ �= .
Mission Real Estate Group Inc Mission Real Estate Group Inc
Seller 1-Name as appears on conveyance document Seller Name as app son conveyance document
I° u 943 I08fa0 mafhSV'
Address(Number
raand
'Street) Address(Number and Street)
1-r7
City,State,and,k Code� ` L( 7(o / fotiq
E-mail
IUnder penalties of perjury,I hereby;certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and com to as r ' ed by nd is Rre ared'n accordance wit - 5 al Property Salhs Disclosure Act".
'/ .--f /L'cC/&d"/P
nature of Seller ature of Seller
James M. Chappell. President t l7•s`l9 Jonathan M. oy Vi P n r ' �/ 5 19
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller - f ;pn e( M/DD/YYYY)
-F,BUYER(S /GJ ANTEE(S)=APPLICATION FOR,PROPERTY TAX DEDUCTIONS—IDENTIFY,ALL I: MS 1 ,k'F-2 I I'1.„' .I7 :; ,,,
I/ Dyllon T. McCarley
-z`u.yPr t-Noma ao arson conveyance document 1 Buyer 2-Name as appears on conveyance d (r(tr�ht® 2019
OAS Al ki 3rel S.) 7
Address\4, � (Number and Street) - Address(Number and Street)
) •I ,trl re1oi , M_-- .ic,a3r7 l�,r _ ,%>?11-1
City,State,
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPE . IDENTIFY ALL OF THOSE THAT APPLY.
YVNO CONDITION YES NO CONDITIO
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary 4.Solar Energy Heating/Cooling System
residence,including county:
(85a C Atuk,,S-4- ❑ ❑✓ 5.Wind Power Device
Address(Number and Street) r ❑ Z 6.Hydroelectric Power Device
1"fl &,? "1
n 1 f1(iri0 eielo10 1 ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State Code County
[I 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 ❑ 0 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.)
Address(Number and Street) / /
City,State ZIP Code County ,2� —4� _ 0 g _r� poi. fOP _O2 S
Primary property owner contact name E-mail
Number License/ID/Other Number