HomeMy WebLinkAboutHomestead_AgeeISCLOSURE FORM � SDFID:
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, Preparero(NeSalaDSdosvreForm
Evansville In 47715
[iry, SmrG and ZIPCade
Shcer I- Name as appeirs on canveyonce document
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Addrm (Numberand Street)
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Reaional Land Title
Lompany
E�mail
Seller 2- Name as appma om m�veyonre documm[
Address (Number and Sveet)
Ciry, Srute and ZfPGode
Under penalties of perjury, I hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and comple[e as required by law, and is prepared in accordance with IC 6-11-S.S, "Real Property Sales Disclosure Act".
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TNE $AI.F_S DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIY UEDURIONS FOR
YFS NO CONDRION
�✓ � 1. Will this property be the buyer's primary
residence? Provide mmple[e address of primary
residence, induding county:
a4u o� i n i�d i� < lJ�.,,,, �ll
Ciry,Smrell ' Counry
� oes [he huyer have a homesre ndiana to be
vacatedfor[hisresidence? Ify r vide
comple[e address of residence vacated,
induding counry:
Addrgs (NCf1�ber and Stree[)
[Iry, Smte ZIP tode taunry
Buyer 2- Name os appears an romeyanre dotumm[
Address (A'umber and Sveet]
liry, Smt¢ and ZIPCade
IDE.YTIFY ALL OF
Q � 3. Homes[ead
�_ n 4. Solar Ene�
System
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❑ J . m ev�ce
❑ ❑✓ 6. Hydroelectric Power Device
❑ ❑d 7. Geothermal Energy Hearing/Cooling Device
� �✓ 8. Is this property a residenrial renral property?
� Q 9. Would you like to receive tax sta[ements for [his
property via e-mail? (Provide contoct information
6elow. Please see instructlons far more informadon.
Not available in al! tounties.) .
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E-mail
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correc[
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Ad". (Note:
Spouse informatlon, Soc�al Se rity and Driver's License/Other numbers are not necessary if no Homestead Deduc[ion is
being filed.) � � j�/`�� ,
�nnredLegalNameo/BUyu] U S%v+�Dafe(MH/DO
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Signomre of Buyer2/Spouse
Pnnred Legal Name ofBuyer I/Spouse
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LastSdigitsofBuyer2/SpouseDriver"s Smte LastSDigicso(Social5ecunry
Num6er License/10/OtherNumber ,