Homestead_Mull INDIANA SALES DISCLOSURE FORM SDI:ID Pay 2
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... f � "'1.1 .ems._.. �cat.+,�.'^-"^`;y✓ _�.:.._w ti... '�" '-" -��-�� ' �Elysea M Ledman Settlement&Quality Assurance
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive,Suite C • Columbia Title. Inc.
Address(Number and Street) Company
Lafayette, IN 47905
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William Hopper Karen A. Hopper
Seller I-Name as appears an conveyance document Seller 2-Name as appears an conveyance document
104 Harrison Drive 104 Harrison Drive
Address(Number and Street) Address(Number and Street)
Vincennes. IN 47591 Vincennes. IN 47591
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 b law,and is prepared In accordance with IC 6- 1-5.5,"Rear•oper• ales Disclosure Act".
Sg reofSeller Sig lure of Seller ` 1 1
i • Kar n A.Hopper 12/16/2019 ,
Printed Name ofSeller \ S n Date Mai DD Printed Name Seller Sign Date(MM/DD/rin)
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Mindy Mull
as appears on conveyance document Buyer2-Name as appears on conveyance document
Addr (Number and Street) ^ t Ad umber and Street)
E-mail Telephone Number nn E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPL4 ec 20 2019
YES NO CONDITION )t NO CONDITION ilais
g) ❑ 1.Will this property be the buyer's primary a El 3.Homestead IBSON COUNTY AUDITOR CB
residence? Provide complete address of primary �—��iter eating/Cooling System
residence,includingo nt
LIDL ip • rs6 - -- y' ( ❑ 0 5.Wind Power Device
Address(Number ant St-reet) —1 I ❑ 0 6•Hydroelectric Power Device
`r } �� ——ee! to ! 1(�} t p� /�{J ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 4 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 ❑ EZI 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: helow,Piea-se-see_in coons for more information.
Not available in all count' .
Address(Number and Street) 26-12-07-103-001. 037-028
City,State ZIP Code County V �
License/ID/OtherNumber