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GQDIA�A SALES DISCLOSURE FOR,N SDF ID SDO ID 705192 �'age?
EPARER ' � -"
Laura BoYle Mortgage Loan Officer
Preparerof the Sales D'uclnsure Form 7fde
4407 Theater Drive Evansville Teachers FCU
Addres(KUmberand5oeet) Company
Evansville, IN 47715-
E. SELLER S GRANTOR S ' - ' -
Tod S. Bailey Phyllis Bailey
Seller 1- Nome as a➢yean om m�veyana docummt Sel/er 2- Name as appears am m�v9nnce docummc
679 S. Poplar Hills Drive 619 S. Poplar Hills Drive
Address fNumberand Streel) Addre.R (NUmber and Slney
Princeton, IN 47670- Princeton, IN 47670-
Ciry.Stare. and ZIPCode lip; Smte, andZlPCOde
E-moil
Under penalties o(perjury, 1 hereby certi(y that this Sales Disdosure, to the best of my knowledge and belief, is true, correct
and complete a equired by latv, and is prepared in accordance wi�ty�C 6-11-5.5, "R Property Sa�es Disclosure Ac[".
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Si n 2reof elier naareof5ell
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F. BUYER S GRANTE6 -APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFYALL ITEMS THAT-A P�Y
Mna E. Roth -
Bvyer 1- flame os appearson conve�vnce documen� Buyer 2- Name os appmis on t'onveyvnce docummt
�S. Poplar Hills Drive
—dres (Num6er and Sveet) Addrus (A'vm6er and Street)
Princeton, IN 47670-
Ciry.Slafe, andZ/P Lode Gry. Smte, cnd ZIPCOdt
E-mail Tele haneA'umbe� Email
THE SlLFS DISCLOSURE FORhi Afqy gE USE� TO APPLY FOR CEHTAIN OEOI1Cf10NS FOR THIS PROPERT'. IDENTIFI' ALL OF THOSE THAT.IPPLY.
1'ES NO C09DITIOY 1'ES NO COYDITION
XQ � 1. Will this property be the buyer's primary ❑X ❑ 3. Homestead
residence? Provide complete address of primary � Q 4. Solar Energy Heating/Cooling Sys[em
residence, including county:
619 5. POPLAR HILLS DRIVE ❑ Q 5. \Nind Nower Uevice
Address(h'um6erand5vee[) ❑ Q 6. Hydroelectric Power Device
Princeton, IN 47670 GIBSON
❑ Q 7. Geothermal Energy Hea[ing/Cooling Device
Ciry.Smu ZlP Code [ounry
�� 2. Does the buyer have a homes[ead in Indiana to be � � g• �s this property a residen[ial ren[al proper[y?
vacated for this residence? If yes, provide ❑ Q 9. Would you like to receive tax stacemencs for this
compleie address of residence being vaca[ed, property via e-mail? (Provide contact in�ormodon
including county: below. Please see instrucdonsfor more in/'ormation.
Not available in all counties.J
Addras (Num6er and StreetJ /
/7%�-//-/.�-�'�o�-G�.OIo (7�- �� �
Ciry.SmmZ/PCOde Counry
Prfmary praperry owner ronmtt nume Email
Under penalties of perjury, I hereby certify [ha[ this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and co plete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (\o[e:
Spou nform [ion Soc' curity arid Driver's License/Other numbers are no[ necessary if no Homestead Deduc[ion is
b 'n led.)
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Si namreo(Buyerl q SignamreofBuyer2/Spovee
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LnstSdigitso(Buyerl0river"5 Stare Los[SDigitso(SocialSecuriryNumber Las[SdigiuojBuyer2/SpouseDriver's Smre Las(SDigltrofSocialSecurity
License/ID/OtherNum6er Numbe� License/ID/O[herNumber