Homestead_BobbittINDIANA SALFS DISCLOSURE FORM SDF ID: P'a e.2
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MARYUM A.THOMAS SETTLEMENTAGENT
Preporer of Ne Sala Disdmvre £orm TGe
03 THEATER DRIVE REGIONAL LAND TITLE COMPANY
Addr� (Num6erand StreetJ Company
EVANSVILLE. IN 47715
E-mail
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Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and w ete as required by law, and ' repar m acwrdance wi[h IC 6-1.1-S.S, "Real Property Sales Disdosure AcC'.
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SignoNre o(Seller 5(gnaNre o/Seller
Christopher A. Der.ker 08I03/2070
PdnredNameo Selfer SiunDare .xn/OD PnnredA'amea Seller SionDau(sN/ou
?E: B � " - . �r� � , . ' ATION:F.OR'PROPER77;TAX�DEDUGTtONS=,';IDENTIF.Y,+'Al:l.'ITEMS4THAT APPGY�`'-�"�`�a�`^' �S��u�=�:
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. uyer]-Nameasoppevrsamm�vevunce en[ 6uyv2-Nameasappearsomm�veyancedocvment
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Addr� (Number and Street) Add� (Numberand Street)
��nceton IN 47670
TO APPLY FOR CERTAIN DEDUCf10N5 FOR THIS PROPERTY. IDENfIFY ALL OF THOSE TNAT APPLY.
YFS NO CO\DI770N I YES NO COYDRION
Q � 1. Will this property be the buyer's primary Q✓ � 3. Homes[ead
residence? Provide complete address of primary � � 4. Solar Ener� Heating/Cooling System
residence, including county:
1001 E Ohio ctreet ❑ S. Wind Power Device
Addras(Num6erand5o'te[) ❑ �� �6. Hydroelectric Power Device
Princeton. IN 47670 Gibson � ��,}'/ 7, Geothermal Enerw Heating/Cooling Device
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� � 2. Does Che buyer have a homestead in Indiana to be � L1 6� �s this property a residential rentat property?
vaca[ed for [his residence? If yes, provide ❑ �9• Would you like to receive tau statemen[s for [his
comple[e address of residence being vaca[ed, property via e-mail? (Provide contact information
induding counry: 6elow. Please see instructlons far more informadon.
Not available in a(I mqund///es���.)
Addren (Num6er and StreetJ . I 0 3� V�Y ����� p�g
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Under penalties of perjury, l hereby certify that this Sales Disclosure, [o the best of my knowledge aud belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1•5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being filed.)
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Sgnamre o(Buyer7 5(qnamre o(euyer2/Spouse
�iamin Rnhbitt 08/03/7010
s$�'n' LegalA1meofBuyer] / SignDate(.xH/DD/YYYr) ➢n'ntedLegalNameaJBuyer2/Spouse SjgnDa[e(MM/DD/YYYYJ
LastSdigitsofBuyeriDriver's Sra[e LastSDigiao%SocialSecuntyNum6er LastSdigi[safBuyer2/SpouseDriver's Smte Las[SDigiGSOjSocial5ecunty
License/10/OfherNum6er Num6er License/ID/OrherNum6er
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