Homestead_Godby INDIIAp L'
NpASApLpES DISCLOSURE FORM SDF ID Page 2
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Timothy Shea Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville,IN 47715 (
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Thomas H.Carney
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
5012 S Lincoln Street
Address(Number and Street) Address(Number and Street)
Oakland City,IN 47660
Stale,and
Telephone Number E- Telephone Number E-mall
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and lete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature ofSeller���� Signature of Seller '
Thomas H.Carney / ' t) L 1 9
Printed Name of Seller Sign D to(MM/D/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
Ii.eB Ell(Sl o- EB S '.41AP LIL3A I?IONtIi t rt IPER Y'?rktibED.U( titii IDENTIFYrALL 41-84§PII<ALAPIPLYeLV' ; "M; `
Cody Godby
pears on conveyance document Buyer 2-Name as appears on conveyance document
5497 Eden Drive '
Address(Number and Street) Address(Number and Street)
Evansville,IN 47715 //
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CERTAIN DEDUCTIONS FOR THIS PREE . ENTI OSE THAT APPLY. Dec/�� 02 2019
YES NO CONDITION / YES NO CONDITION J t...., „y
❑ 1.Will this property be the buyer's primary 3.Homestead GIBSONN CO`'UIN'TTY�A'`UDITOR CB
residence? Provide complete address of primary IA 4.Solar Energy Heating/Cooling System
residence,including county: Q 5.Wind Power Device
5012 S Lincoln Street ❑
Address(Number and Street) ❑ Q 6. ydroelectric Power Device
Oakland Ci -,IN 47660 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
crty,statez Code County ❑ 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ Q 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
property via e-mail?(Provide contact information
complete address of residence being vacated,
including county: below.Please see i ' nstor mot- " motion.
Not availab ' .all counties.)
Address(Number and Street) Cody Godby 6-20-02-204-000. 009-003
City,State ZIP Code County Primary property owner ontact name all
License/ID/Other Number