Homestead_RickettsI��IANA SALES DISCLOSURE FORM SDF ID: Pa e 2
':DnP- � j-.. �E? n �Ce�`5.' `.`s^_%� �—r,.m.: F y a v;3 � �. x.�'ti � R �°3 t-.'3'zy _ � : -�cc � � r4�: v-- x � S'�� ,."�i
REP„ARER ..� �'�:.t�,.a....-�zs�.,.at�_�� —x+�.�- �.<:�.3x..,��.c.� _.'-�;`:�.,.. �a _�a.: �`a���:.�`� 2._ ..�'�.u�_<.. :,.: ..�.
Caroline Schneider Ciosina Aoent
Preparero(rhe Salu Diulosure Fortn Tide
915 Main Street Suite 600 Reaional Title Services LLC
Address(Numberand5mee[) �ompa�y
Evansville IN 47708
E-mail
r -i " - ,l�.q- g }..�. .> '� �:'�� r �i .� c- . �'_''�`': �1:...32,. �.. ,.�._��a�, � � c ����
,E::SEliLER 5 .GRANTOR $ s.�:.a'� ��s.,z..ti il, . �.,_�L _.. �...�,.., �.. . .:,. �.. _ _�.153 _....,,
Karcn f`pppp� '
Seller 1- Name as oppmrs on conveynnce dxumen[ Seller 2� Name as appears on mm�eyanre docvment
9444 Vanc �ver
Address(NumberandStreeQ Address(Numberond5vee[J
North Port, FI 7d�Afi
City.5mt4 and Z!P lode Ciry.Smte, and ZIPCOde
of pe 'ury, 1 hereby certify [hat [his Sales Disclosure, [o [he best of my knowledge and belief, is [rue, correct
and �ompl te as req i� d aw, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
ign mreo(Sefler SignaolreoJSeller
KarPn(�OOpPI BI3OIZOIO
PnnredNameaSeller SianDateMMDD PnntedNameaSeller SinnDateWHOD
FFSBUYER S� GR;4NTE6 S_ e1PFL'ICATIONsF.OR:P,ROP.ERTY;TAX�DEDUCTIONS= IDENTIEY ACL'="ITEM$�THATAPP.GY ,,�'�`,:: .3?;{: `:
Sandra Ricketts
Buyerl-Nameasappmrsan nvqnncedxument Bvyer2�Nameasappearsonronveyvncedocvmm[
320 oru ee
Address (Nvmber and Svee[f Addres (Num6er and5tree[)
Princeton IN 47670
•Ciry, Smre, and Z/P lode Ciry.Smre, and ZIPCade
f-mail iele honeNumber E-mo
THESALFSDISCLOSUREFORMMTVBEUSEDT0.IPPLVFORCERTAIYOEUURIONSFORTNISPNO " FT OSETHAT PLY. �1 (y��`�'
YES NO CO\DITIOY Y �0 COYDITION ��I��77—�w��^
�✓ � 1. Will this proper[y be the buyer's primary ❑J ❑ 3. Homestead
residence? Provide complete address of primary ea[ing stem
residence, including county:
18Qd S Old l IC 41 ❑ ❑✓ 5. Wind Power Device
Address(h'umberand5veet) ❑ ❑J 6. Hydroelectric Power Device
Princeton IN 47670 Gibson __ � Q 7. Geothermal Energy Heating/Cooling Device
Ciry, Smce ZIP lade Caunry
� Q✓ 2. Does the buyer have a homestead in Indiana [o be � ❑� 8. Is [his property a residen[ial rental property?
vacated for this residence? If yes, provide ❑ ❑✓ 9. Would you like [o receive tax sta[ements for [his
complete address of residence being vaca[ed, property via e-mail? (Provide conmct informonon
induding county: below. Please see instrucdons for more injormation.
Not availa6le in all counties.J
Addres (h'umber and Stree[)
Ciry, Smre ZIP fode Gounry
PnmoryOroPerryowner mnmR name E-mail
Under penalties of perjury, I hereby certify [ha[ this Sales Disclosure, [o the best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse informa[ion, Sot' I Security and Driver's License/Other numbers are no[ necessary i( no Homestead Deduction is
being filed.)
,� �Ao�
5(qna[ureofBy�erl Signomreo/By�er2/Spause
�Cnn�Vr� R'r4ottc 6/30/2010
�,�
Las[SdigirsofBuyerl0river's Smte LoscSDigi¢o(SxialSecuriryNum6er LostSdigicso/Buyer2/SpouseDriver's SWte Las�SDigiao�SocialSecuriry
License/ID/OtherNum6er Num6er License/lD/O[herNum6er
��