Homestead_ScottL�"D41\ASALESDISCLOSUREFORDI SDFID SDOID 936418 �
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'D. PREPARER - - . - . . .. - � - � . - - . - - . . - .
Peggy A. Conner Title Pssisiant
Prepartro(tAe Salc D'¢dmvrc Fo(m p'�e
3707 N. Green River Road Suite 130 Trusiworthv Land Tiile Co. Inc.
Add'¢s(NumberalMS:rert) Compam•
Evansville, IN 47715
.E.SEliLER S GRANTOR S � �- - � �- � � ' ' ' � � � - � � �
Carol E. Linxwiler
Sellert-Rome¢sappeorsamm�vryvnredocumen[ Sr/Ier2-Namrosu rsonronv
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323 S. Main SVeetApt. 126 �
AdCress (Numba and SveeQ Addrrs (BUmberartOStreetJ
Princeton, IN 47670.
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Under penal[ies of perjury, I hereby certify tha[ this Sales Disclosure, [o [he bes[ of my knowledge and belief, is true, correct
and complete as required by law, pnd is p/r� pared in accordance wi[h IC 6-L1-5.5, "Real Property Sales Disclosure Act".
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."namreo(Selfer � Signam�eo(Selle�
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F:B RANTEE S-APPLICATION FOR PROPERTY TAX DEDUCTIONS-iDE�TIFYALL ITEMS THATAPPLY
Randol h W. Scott
Buvn 1- Nome ntappears on conveyanre documenr Bwer I- Name os npptors on ronvnvnce danmenr
- 329 S. Sth Avenue Apt. 65
Addreu(A'um6erand5treet) Addres(NUmberond5vee[)
Princetan, IN 47670-
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E-mail
THE SAI.FS DISCLOSURE FURM MAl' BE USED TO APPLI' FOR CERTNN DEUURIONS FOR THIS PROPER7Y. IDEKfIFY ALL OF TNOSE THAT APPLY'.
YES YO C09DITIDN Y� NO CONDITION-'-'�-._.
❑X ❑ 1.lNill this property be the buyer's primary X 3. Homestead
residence? Provide complete address of prima
� Q 4. Solar Energy Heating/Cooling System
residence, induding county: � � 5. Wind Power Device
4662 N. SR 65
Address(NV.r.bercridShre[) �� S a ❑ Q 6. Hydroelectric Power Device
Patoka, IN 47666 NOTAPPLICABLE � � �, Geothermal Energy Hea[ing/Cooling Device
G9•.Sm¢21PCode Counry
❑� 2. Does the buyer ha��e a hom=siead in Indiana m be � � 8� Is this property a residen[ial rental propercy?
vacated for this residence? If yes, pro��de ❑ � 9. Would you like ro receive tax statements for [his
complete address of residence being vacated, property via e-mail? (Provide contact information
including county: below. Please see instrucdons for more informadon.
Not available in alf caunries.)
Addrm(NumLeraMSUret) a�-os - s� � io �. ood. 9��-0� �
Gry, Smu ZIP Codr Coun.y
Pn.avrvpmxm ownerrnnrutt rumr E-moil
Under penaldes of perjury, 1 hereby certify [hat this Sales Disclosure, to the best o(my knowledge and belief, is true, correct
and complete as required by law, and is prepared in acwrdance with IC 6-11-5.5, "Real Proper[y Sales Distlosure Act". (No[e:
Spouse intormation, Social5ecuriq� and Driver's License/O[her numbers are no[ necessary� i( no Homes[ead DeducUOn is
being filed. -�'�c V '
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