HomeMy WebLinkAboutHomestead_EngelbrechtI�OL4NASALESDISCLOSUREFOR�1 SDFID SDOID 722311 I'agc2
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D: PREPARER __ _ - _ ;: _ ? —
Caroline Schneider
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820 Eagle Crest Bvd Suite 201
Addrcss (h'umbe� md St reefJ
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Regional Title Services LLC
CamPonY
Evansville, IN 47715-
E�mail
E. SELLER S GRANTOR S' �'
VJilliam M Pugh Malinda A Pugh
Seller 1- Name us cppevrs om m�reyvnte dorument Seller? - Nam^ m opynrs on mm�eyvnre dutvment
16939 Roscommon Road 18939 Roscommon Road
Addros jXum6rrondSVeey AQdrcs(XUm6QandSn��J
Evansville, IN 47725- Evansville, IN 47725-
dry, Smrc aiML➢Cade Gry.Sm�e, ond Z/PCOde
£-moil
Under penalties of perjury, 1 hereby c� � t t this Sales Disclosure, [o [he 6est of mp knowledge and belief, is true, correct
an co �pl as required b w, an is prep e' accordance wit� -I.j-S.$, r�al P�pe�le isc osure Ac[".
.flgncdreof5dler 5(qnomr ofSel�f,ler�"�
William M Pugh 8/9/2011 Malinda A Pugh /9/2011
Jason A
8 1�5 Mallory Coutl
AEdrea (Xvmber a�d streeq
Evansville, IN 47725
Code
Carrie A Engel6
_ Rvyrr 2 - A'ome as
Addrea (7(umber arsd SaeetJ
Evansville, IN 47725-
Gpt Sm:e. and ZIPCOCe
THE SALES DISCLOAIRE FONM1I MAY BE I1SED TO APPLV FOR CERTAIN DEDIICf10NS FOR THIS PPOPERTY. IDENfIFY ALL OF THOSE THAT APPLI'.
U U 1. lNill this propern� be [he buyer's primary
residence? Provide comple[e address of pn a
residence, including county:
1036 N. MAIN STREET
4ddrrss jh'umbervnd StrretJ
Princeton, IN 47670 GIBSON
Gp�. Smre ZIP Code luun9•
❑X ❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including coun[y:
8815 MALLORY COURT
� 3. Homestead
Hea[ing/Cooling System
� � 5. N�ind Power Device
❑ Q 6. Hydroelectric Po�aer Device
❑ Q 7. Geo;hermal Energy Heating/Cooling Device
� Q 8. Is this property a residentlal rental property?
❑ Q 9. Would you like to receive tax statements for [his
property via e-mail? (Provide contact informoUOn
6elo�u Please see instrucaons for more informatimi.
h'ot availa6le in afl counties.)
Address j;lmncerand5vxt) ' �Vf /j�/ /y�
Evansville, IN 47725 ADAMS �� �/a�/(/ �- �(/�",J'W/ 9�3� Lt�'O
Ciry;SmreZlPCOde Counry �CY �./S54
Pnman•v�Dart;� ownm conmct name £-mail
Under penalties of perjury, l hereby certify tha[ this Sales Disclosure, to Che best of my knowledge and belief, is [rue, correct
and complete as required by law, and is prepared in accordante wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information Soc� urity and Driver's LicenseJOther numbers are not necessary if no Homestead Deduction is
g filed.) . <�� J
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