HomeMy WebLinkAboutHomestead_Bailey (3)I\DUilA SALES DISCLOSURE FOR\f
SDFID
SDO m 758858
Pa�e 2 \ \
-0: PREPARER--. , _ . . : . � . . . . -�- _ �. . . . .. � ... . . . . .. _ ,:
Peggy A. Conner TiUe Assistant
Prepvro a/the Sala D'admvrx Form iitle
�i101 N. Green River Road Suite 730 Trustworthy Land TiUe Co., Inc.
Address (Numbe and SoertJ (qmpom•
Evansville, IN 47715
t-��)
:E:SELLER S GRANTOR S � � � � ' ' - � � � � � � -
Mark Fulcher
Se//er 1- Name as appears om m�veyvnrc dotvment SNler 1� Namt at appears on mm�e�vnte dotvmmt
957 Highway 4176 W.
Addres /Number andStree:) Addre.ss (NumGer end StreetJ
Henderson, KY 42420.
Ciry�.Smte, ondZ/PCade Ciry. Sm�t. nnd LPCnde
E-mail Tel honeNumber E-mall
Under pena of perjury 1 hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and tompl , e reqq� � y law, and is prepared in acwrdance wi[h IC 6-11-5.5, "Real Property Sales Disdosure Ac[".
� �'
/
r oneo� e Signaolreof5eller
1 t a�-��lC1-' � �-� -1 ,-la
,
F � TEE S -aPPLICATIONFORPROPERTYTAXDEDUCT10N5-IDEtv'TIFYALLITEMSTHATAPPLY � �
Tana L. Bailey
Bvverl�Nome¢tn on(anveynnredx�ment Buver2-Nameosnppearsanronvn�oncedon�ment
6218 Wg VJam Drive
Ad ress �. andSmtr) AddresslNUmberondStreeO
Evansville, IN 47715-
Ciry. SmtG andZlPCOde G9} Smu, andZlPCode
�
Tele honeNumber E-maif iele MneMUmbtr E-moil
TNE SALES DISCLOSURE FORM MAl' BE USED TO APPLI' FOR CERT.V N DEDULTIONS FOR THIS PROPERTY. IDEhTIFY ALL OF THOSE TF41T APPLI'.
YES YO CO\'DITI�N NO CONDIllOY
Q � 1. \1'ill this property be the buyer's primarrr I�x � 3. ad
residence? Provide complete address of primary 4. Solar Energy Hea[ing/Cooling Sysiem
residence, including county:
7012 CENTER STREET S ❑ Q 5� W�nd Power Device
Addmr(NUmberand5vret) ❑ Q 6. Hydroelectric Power Device
Fort Branch, IN 47648 NOT APPLICABLE
❑ Q 7. Geothermal Ener� Heating/Cooling Device
Ci9t SmreZIP Code [ounry
x� � 2. Does the buyer have a homestead in Indiana [o be � 0 8� �s [his property a residenaal rental propercy?
vacated for this residence? If yes, pro��de ❑ 0 9. WoWd }�ou like to receive tax statements for this
complete address of residence being vacated, property via e-mail? (Provide contact informotion
induding county: belou•. P/easesee instrucnons for more informadon.
6278 WIG WAM DRNE Not ovoilable in aU caundes.)
ACdres (NumW cnd Sveet) / j �S
Evansville, IN 47715 VANDERBURGH �lp. 9��� /�J -VQd •�7 %���
Ciry, Sru[e Z1PCade Cnun.y
Piararyproperq�ownerronmctnome E-mai!
Under penaldes of perjury, l hereby certify [hat this Sales Disdosure, ro the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6Q1-5.5, "Real Property Sales Disclosure Act". (No[e:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homes[ead Deducdon is
being filed.) •�
ti �
��Si n [ureoJBUyerl SignatureofBUVer7/S�ouse
1 .u, L. 1��'c ��O.L —� .—l�
Sacia/5xunryNum6er I,attSdigiCCOfBuyer2/SpouseDnver's Smte LastSDigi¢a�5otiol5ecuri[v
License/!D/OfherA'umber Number License/ID/O[herA'umber