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I�'D/1\A SALES DISCLOSURE FOR�I
SDF ID
SDOID _ _463620
Pege 2 �
D.PREPARER
sta Wallace Typist
rtparerofNe Sates Dittbsurc Form titlr
605 S. E. Martin Luther King Jc BNd. Southvrestem Indiana Land Title
Address(h'um6rrand5veet) Company
Evansville, IN 47713
E. SELLER S GRANTOR S
Paul Etlwartls Sarah Edv✓artls
Sellerl ��¢amen�oppeorson[onv¢�vncedo�umme $e!lerZ-NamensapPearsmcon.e�vnredorumen[
10787 W 750 S 10787 W 750 S
Addrezs(Numberand5tm:) Addrecs(h'umberandSVeet)
Owensville, IN 47665 Ovrensville, IN 47665-
G9t Sm4, ond LPCOde Ciry, Smtq and ZIPCode
E-mail
Under penalties of perjury•, I hereby certify that this Sales Disclosure, to the best o( my knowledge and belief, is true, correct
an/d� omnplete as required/by law, and �iqs pr�e.Pared in accordance with IC 6-�} 1-5/.5, "Real Proper/ty SaleSDis losy`re A�c�t"�.
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Signamreo(Seller Signam�eaJSeller . � •
Paul_Edwards�� Fmily Smith, AIF 2/24/10 Sarah Fdwards by Emily Smith, AIF 2/24/10
,
. UYERS GfL1NTEE5 -APPWCATIONFORPROPERTYTAXDEDUCTIONS-IDENTIFYALLITEM1ISTHATAPPLY
Heath M. Roby
Bytrl�Nameasvppr ontmvryan�edo�vment Quyerl-,YameosapP�rsonrnnveyonredatvmen[
E fieet
ddreu(Numhe�andSnert Addrecs(Num6e�andSVeee)
°l Bran . 47648-
�Y. Srote, and "LIPCodr Ciry.Smte. ond LIP Codr
/
Tele honeNvmber P-maii Tele honeA'umber E-mpil
THE SALES DISCLOSURE FORM N,1Y BE USEU TO APPLY FOR CERTAIN OEOURIOYS FOP THIS PROPERTY. IDENTIFY ALL OF TNOSE THAT APPLY.
YES NO COYOITIOY Y NO COVDITION
�x � 1. Will this property be the buyer's primary ❑X ❑ 3. Homestead
residence? Provide complete address of prim � Q 4. Solar En ,- Heating/Cooling System
residence, including counry: '
303 E. FOS7ER STREET . ind Power Device
Addrtss(Nurnberand5neetJ � Q 6. Hydroelectric Power Devi�e
FL Branch, IN 47648 GIBSON
❑ Q 7. Geothermal Energy Heating/Cooling Device
Ciry.SmuZIP[ode Counry
��] 2. Does the buyer have a homestead in Indiana ro be ❑ � 8. Is this property a residential renul property?
vacated for this residence? If yes, provide ❑ � 9� Would you like to receive tax statements for this
mmplete address of residence being vaca[ed, property via e-mail? (Provide conmct in%rmotion
including councy: below. Please see instructions for more inforrnatian.
No[ nvailable in all rounties.) �
Address(,¢um6eramJSaee[) �(Q ^�9 �9-��i o�10 . o s� aa
Ciryt Srutr Z/PCWe Counry
Primary pmperry owner mnrna name E-mail
Under penalties of perjury, I hereby certify [hat this Sales Disdosure, to the bes[ o(my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Property Sales Disclosure Act". (No[e:
Spouse informadon. Social Security and Driver's License/Other numbers are not necessary if no Homestead Deductlon is
being Filed.)
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�SignaNreofBuyrrl � SqnamreafBVVer2/Spouse
Heath M. Roby by Fmily Smith, AIF 2/24/10
�nredLegnlBameofBy'al $ignDale(HM/U�/YYYI) PdntedLeyalNameoJBuyer7/Spouse SignOare[.vK/OD/YY»7
Lat[Sdi,qi[so(BuyerlDri�er's Swte GartSDigi[ro(SocialSecuriryNumber Las[Sdigifso%Buyer2/SpouseDnver't Sm[e LastSDigi[sa(Social5eturiry
License/ID/Otherh'umber Number License/lD/O[herNumbe�
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