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Homestead_RichesonINDtANA SALES DISCLOSURE FORM SDF ID: Pa e 2 - . - .. .,� ,.-. :D.PREPARER',."....'°�,'�'NT �ot..':`..%d'.`_Y ,. i� � 's���, a� a .,�_�s,t'[e �ti_�.��w.s���_:c`ry,:.. ._ K"'i-._$.�i;"r�; s �r^ i.:�-_ �t Laura Rininoer Closino Coordinator Preparrr o(rhe Salc Disdosure Form 15t1e 820 Ea le Crest Blvd Ste 207 Reqional Title Services. LLC Addres (h'um6er and SveetJ Cig; Smte, ond7JPCade Telephone Num6er E-mail ESELLER S GRANTOR S �y' ,.c;.. *�_-.+' , ` _ � a:.•4z. ;� _ Nettv IIe. Seller ]- Name as appmrs om m�vevonre dotvment Seller2 - Name as appmrs on conveyunre docvment 3�7 W 400N Addras(Numberand5treet) pddrgs(Numberand5treet) Patoka. IN 47fifi6 Cin:Srnte, and7JPCode CiN Srutg andTJP lode E-muil Tde honeM1'umber E-moil Under penal[ies of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, wrrect an omple�t'e as re�ui{�ed by la�and is prepared in acc_ ordance with IC 6-1.1-5.5, "Real Property Sales Disdosure Ac[". �Q ��n � o� .bJL_Q L� c d..e.-. S�gnomreo/Seller SgnomreofSvJler N� IIe by L� Ile Attomey in Fact 70/1N2012 PnnudNameo(Sdfer SianDa[e(xM/on Pnnraih'ameo Seller SIOODUI¢ MM/OD F.BIJYERS GRANTEBS �-APPLICATIONFORPROPERTYTAXDEDUCTfONS-1DENTIFYAI.LITEMSTHATAPPLY-':.:<'.`-�.�+.�=�`;'�i- Travis J. Richeson Buyer ]- Nameas appmrs am m�vevance dxvment Buyvl2 - Name as appevrs on romeyanre dacument 8815 450E Addras (Num6er ond Sveet) Addrm (Number and Stree[) rancisco IN 47649 .iry, Smre, and ZIPCade Cig; Sm�e, and LP Code Tele honeNumba E-mvil Tele honeNUmbu E�mail TNE SALFS DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAI.Y DEDUC710N5 FOR THIS PROPERTY. IDENTIFY ALL OF TNOSE TNAT APPLY. 1'FS YO CO\DITION I YES NO CONDRION ❑J � 1. Will [his property be the buyer's primary Q � 3. Homestead residence? Provide complete address of primary � � 4. Solar Energy Heating/Cooling System residence, including county: 1019 S. Adams St. ❑ ❑� S. Wind Power Device Addras(Numberand5tree[) ❑ ❑✓ 6. HydroelecTric Power Device Princeton. IN 47670 Gibson � Q 7. Geo[hermal Energy Heating/Cooling Device Ci9; SmteTJPCade Counry ❑ �✓ 2. Does [he buyer have a homestead in Indiana to be � ❑� $� �s [his property a residentlal rental property? vacated for this residence? Ifyes, provide ❑ ❑✓ 9. Would you like [o receive tax statemencs for this complete address of residence being vacated, property via e-mail? (Provide conmct information including county: belaw. Please see instructions jor more information. Not availa6le in all counties.) Addras (A'umber and Sveet) '7 �7 Ci9:5rare7JPCode � �o'�IX '� / ' �� / � � /• i 3a � - oa g Lounry Pnmaryproperryoumerronmt[name E-mail Under penalties of perjury, t hereby certify [ha[ this Sales Disclosure, [o the best of my knowledge and belief, is true, correct and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disciosure Act". (Note: Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is beiug filed.) '`J /.� i� i��^�/ Sqnamrea%BVyYr] S(qnonlreafBwe2/Spouse Pnn;edLegalNameo(Bvyerl SignDate(MH/un/YYYI] PnnredLegalNameojBUyer2/Spouse SgnDate(HM/DD/YYY1] �� L¢s[SdigiGSOfBuyerlDnver's Smre Las[SDigiCSO�Social5ecurityNumber LastSdigiGSOfBuyer2/SpouseDnver's Stnte LastSDigiGSOjSorialSecuriry Liceue/ID/OrherNum6er Num6er License/ID/OrherNum6er