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FORM SDFID:
� Laura Rtn(naer Ctos�rta Coordinator
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7820 Eaaie Cres[ BNd Ste 201 Reqionai TI11e Servt�s. LLC
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Evansviiie. IN 47715
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IInder penaItles of perjury, I hereby certity that this Sales Disclosure, tn the best of my knawledge and helief, 'u true, correct
and complete as required(� t�v, an�d is prepazed in accordance wlth IC 6-Ll-SS, "Real Praperty Sales Aisclosure AcC'.
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� aa21 E. Riverside Dr.
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�Evansvill IN 4P74
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Broake E Klein
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4421 E Poverside Dr
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Fvansville IN 477't4
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THESALFS01'QOSUREF6AMIMY6CUSmTOMPLYFOR�RTMV➢mI1L710ti5F0AiHLSPROPERiY. mEtf�7FVALLOFTNOSBTRATAPPLV.
Q✓ ❑ 1. Will this property be the buyer's primary
residence? Prov(de camptete address of primary
restdence, (ncluding councy:
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n dema (Number acd: baetl
Princeton IN 47670 Gibson_
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� 0✓ 2. Does the buyer have a homestead in [ndiana to he
yaated for this residence? IFyes, provide
rnmplete address of resldence hetng vacated,
including counry:
.W1ren (NUmSeramt Sttct)
Gry,SrotellPfode �O1^4'
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3. Homestead
4. Solar Eoe�gy Heating/Cooling System
S. Wind Power Device
6. Hydroelectrlc Power De-rice
7. Geothermal Eneigy Heiang/Cooltng Dev(ce
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8. Is [his property a ruidential rental property?
9. Would you Iike to receive tax scatements for this
property via e�mail? (Provide contatt information
below. Please see instructions for more iajormadon.
Not available in al( counUes)
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Under penaldes of per}ury, [ Lereby certify that this Sales Disclosure, to ihe best nf my imowledge and belief, is ave, correc[
and compiete as required by law, and Is prepared in accordance with [C 6-1.1-5.5, "Reai Property Sales Distlosure AcC. (NOxe:
Spouse informatton, Soaai Securiry and Drivers Lfcense/Other numbeis are not necessary [f no Homestcad Deducdon is
be`/ing filed.) //i —�
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La:tSd(qftrojBuyerl0rive/s � te LartSD(qfao/SvtalSea:riryNum6er
License/1D/Ofh er Number
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