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HomeMy WebLinkAboutHomestead_EaglesonL�DL1\A SALES DISCLOSLRE FOR�I SDF m SDO m 679399 11.- � pap�'' Crista Wallace 'PreyarerofNt5alu0trdosureForm 605 S. E. Alartin Luiher King Jr. Blvd. ACdress (Num.ber end Svn[) Evansville, IN 47711 Qry. Smte. andZIPCoCe Heather J. Mounis Balley Seller 1-Name as appears on convqnnu Eoaumrnt 705 E. Ulen Street Addrrss(Num.be; cnESo-n:) Ft. Branch,IN 47646- Ci.y, Sm:e. and ZIFCode Tidr Souitnvestzm Indiana Land Title � Comp�ny Se17er I� Name as appeors on canveyana docvment Addrtss (Num6er and S[reec) Ciry, Smfq md ZlP f.odr Under penal[ies of perjury, I hereby cer[ify that this Sales Disdosure, to die bes[ of my knowledge and belief, is [rue, mrrec[ and/ complete as required /by l�a?-w, and is pCrePaQred� ^in a1c',cordance with IC 6-1.1-5.5, "Real Property Sales Disdosure Act". 't0/.i'����T �Ci(nT� /�i��S'�/i�^�'�11vV,"7�!.Al�� ha�S. Eagleson � �,vamea:�opm� Ft Branch, IN a76a8- Ciry.Sm�e, and ZIV CeEe 5(qr.emis o/Seller Quyer d� Nome as appears om m�veyunce ervmen: . ARd�uv(Nmnberand5treet) Cih. Smh, nnd ZIPCade THE 5,1LE5 DISCLOSURE iORM M,1Y BE USED T0.IPPLY i0R CERT,IIA DE�UCfIO\5 FOR TMIS PROPERTY. IDE\TIiY ALL OF TNOSE THAT APPLY. X� � 1. 4Vi11 [his property be the buyer'S primary residence? Provide complete address of prima residence, intluding county: 705 E. ULEN STREE7 AUdres (h'umber ar. d SveetJ Ft. BranUi, IN 47648 GIBSON City, Sm[e LP CoCr Counry �� ?. Does the buyer have a homes[ead in Indiar.a to be vacated for this residence? Ifyes, provide wmplete address of residence being vacated, induding county: - Q ❑ 3. Homestead � K i a t i F o,.uo�: o^'oalingSys[em � Q 5.4Vind Po�ver Device � Q 6. Hydroelettric Pawer Device � ❑ Q 7. Geothermal Energy Heating/Cooling Device . � Q 8. I5 this property a residen[ial rental property? ❑ Q 9. Would you Iike to receive ta�c scatemen[s for this property via e-mail? (Provrde mnmct information 6elow. Pleose see instrucdons for more inforrna[ion_ iVot available in al! counties.J Address (NumCerond5oeetJ �� � �I-�s�3�a-�� �a ioa� Ciry. 5stt LP Code Counry Pri.mcrvom�ernownomnmctnumr E-nail � Under penalties of perjury, 1 hereby certify that this Sales Disdosure, to the best of my knowledge and belief, is true, correct and comple[e as required by law, and is prepared in accordance }vith IC 64.1-5.5, "Real Property Sales Disdosure Ac[". (\o[e: Spouse informatlon, Social Security and Driver's License/O[her numbers are no[ necessary if no Hmnes[ead Deductlon is beino filed.) b C tD ` � �A i'I�A,Q�x �1c S G r�;sort �J^1 (•�k�(.y ] iti+ �`r k. }� i I—� Smre Gas[SDigiCSO(Social5ecunyNum6er Si5^a�urr o(Buverl/Spousr Pnn�ed Legal Name o(BuYer 2/Spou,e Sign Dam (MM/00/riYYJ LastSdigiGSO%8u}�er2/SpauseDriver's Smte LastSDigi6a(Sotial5ecunN, M1'umbe� Lirente/10/OtherNumber