Homestead_Beard (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Robert E.Zoss, Sr. Attorney
Preparer of the Sales Disclosure Form Title
2405 N. Green River Road Bob Zoss Law Office, LLC
Address(Number and Street) Company
Evansville, Indiana 47715
1t,�SELLER( irg.WTOA(S)��,: �_" {1;:il: ._ < ,± _.:_:_._. __ _. _ .L._ w_ 0. .a_ ;.o..'1Y-.:r_�_.' . __..u.�m..- ..._' . .r,7 __.
Randy G Beard
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
4/7)5" 5• ,Clr✓t
Address(Number and Street) Address(Number and Street)
0601I IPrd. (17.5(p2-
t •enalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
d co' pl.' as equired y law,and ' prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Se 4 Signature of Seller �Ul,�l�lY!! � U. tl.�
a* ���,,, er
Randy G.Beard ,� 7 gag, - _ _ t, _
Printed Name of Seller Sign ate Ii1M/DD/YYYY) Printed Name of Se'ill I le ' 3 SirtmBBte(MM/DD/YYYY)
LF. $UYfER:(S),1 MITE;E.(S)._ APPLICATI®N,EORPSROPERTYTAX,jDEDUCTI:ONS_, IDE;NTI *Mr 'I 1
v 1 1Vm� Auditor
C athla-L Beard_ 1 duty
Buyerl-Name as appears on conveyance document Buyer 2-Name asapp so ' ( ument sib re
6728 N. SR 65 OAR
Address Number and Street Address(Number an dplitgY A
Hazelton, Indiana 47620
mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑✓ ❑ 1.Will this property be the buyer's primary 4 r0-0-3:71i5Triestead--------7
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
r� residence,including county:Liii ❑ ❑✓ 5.Wind Power Device
f�� ` 3 ✓ 6.Hydroelectric Power Device
A!ftzI, iiul
dress(Number and Street);,,:",;,. ❑ ❑ y
I -u!f-. 6)4b 61 fg',3PL ❑ ❑✓ 7.Geothermal Energy Heating/Codling Device
City,State ZIP Code County
❑ 02.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 ❑ ❑✓ 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
Primary property owner contact name - E-mail
Number License/ID/Other Number