Homestead_DeckerINDIAp:A SALES DISCLOSURE FORM SDF ID: Pa e Z
rD'PREPARER ^ s_. ;` ', �, ,. ..� . ; n r....:. . 'r .'
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Don Dowell Reaional Manaaer
Preparero([hr5a/a DisdosureFOrm Title
07 N Green River Road Direct Title Insurance Aoencv Inc
Addrecs(NUm6Qand5Cee[) Company
Evansville.IN 47715
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iE: SECLER 5 GRANT,OR S ?'� : ° �� '�'• � �4,_ ,. _ a -_, -..
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Ada 1 Mr.Clurkin
Seller ]� Name as apPmrs on mm�eyan[e dotumml Seller 2- Name as appmrs on romryanre doaument
422 NoAh Harl Street
Addrrss (h'vmbuand Strm[J Addras (NUm6er ond StrretJ
Prinr.eton IN 47fi70
Ciry, Smtq andZlPCode Ciry, Smte, and LP Code
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um6er E-mai/ Tde honeNumber E-mail
Under penalties of perjury, I hereby certify [ha[ this Sales Disclosure, [o [he bes[ of my knowledge and belief, is true, corcect
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Ad".
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Signa[ure o(Seller Signoture o(Seller
Rinted a Shcer Si n DalefMM 00 Prin[edNameo Sello Si nOa[e1M.4/DD/YYYYI
:FrB�- ER�S GRi1NTEE S�=' PL'ICATION'FOR�PROPERTY:TAXDEDUCTIONS=ID6NTIFY;ALLITEMSTHATAPPCY"'.�`. � `'�
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�e nveyanttdorummt $vye�2-Nam<asuppearsomm�vryoncedacumen[
_7007 E Ohio Street
Addrets (Num6er ond StrxQ Addr¢s (Num6erond Shee[J
Prince[on IN 47670
'iry.5m[t andZlP Cade Ciry.Sm[t and ZIPCode
Email iele honeNvmber E-mail
THE SALES DISCLOSURE FORM MAY BE USEO TO APPLY FOR CERTAIY DEDURIONS FOR THIS PROPERTY. IDEhTIiY ALL OF THOSE THAT APPLY.
YES RO CONDRIOY YFS NO COYDITION
❑J ❑ 1. Will this property be [he buyer's primary �✓ � 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System
residence, induding county:
a22 North Hart Street ❑ ❑✓ 5. Wind Power Device
Addr¢s(NUmberond5tree[) ❑ Q✓ 6. Hydroelec[ric Power Device
Pnnceton. IN 47670 Gibson � O 7. Geothermal Energy Heating/Cooling Device
[iry, Smt<ZIPCOde Counry
❑✓ � 2. Does [he buyer have a homes[ead in Indiana to be � ❑`� 8• �s [his proper[y a residenrial rental proper[y?
vacated for this residence? IFyes, provide ❑ Q 9. Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail? (Provide rontoct in%rmation
including county: 6elow. Please see inshvctions for more information.
1001 E Ohio Street No[availa6le in all counties.)
Addr¢s(A'vmbervnd5tree[J �� �a . Q �,��,�_ oQ� �a 3.oa �'
Princelon, IN 47670 Gibson hnsropher A. Decker
Ciry, Smte LPCade Counry
Pn'mary pmprrty owner rontac[ name E-mail
Under penalties of perjury, f hereby certify that [his Sales Disdosure, [o the bes[ of my Imowledge and belief, is We, correc[
and complete as required by law, and is prepared in acwrdan[e with IC 6-1.1-S.S, "Real Proper[y Sales Disclosure Act". (Note:
Spouse information, Social Securi nd Driver's License/Other numbers are not ne[essary if no Homes[ead Deduc[ion is
being fil
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SignamreofBvyeil � Signamreo(Buyer2/Spouse
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LastSdigi[safBuyerlDnver's Smle Las[SDigitro(Social5ecuriryNum6er Los[Sdigi[sojBuyer2/SpauseDriver's Smle Las[SDigitsaf5acio15ecunry
License/ID/OtherNum6er A'um6er Lirense/ID/O[herNumber
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