HomeMy WebLinkAboutHomestead_TabornL\D1.1\ASALESDISCLOSUREFORJI SDFID SDOID 1388759 Pa�e?
D.�PREPARER � � � � - � - � � � � �
Pegqy A. Ralsion Title Assistani
Preparerofrhe5ala Diulasurt Form lYtle .
3701 N. G2en River Road Suite 130 Tr�slworthy Land Title Co., Inc.
Address(Numbuand5ueetJ Compo�ry�
Evansville, IN 47715-
-�E. SELLER S GRANTOR S - ' � � ' � - � ' � � � - = �
Brentla K. Rish
Sel/rr 1- Fame as appeorson conceyvn[e dacummt Seller2 - Name as oppears w mnvqmo[e documtrtt
2708 S. Main Street
Addres(NumbacnCSbee:) ' Addrea(NumLernnEStreetJ
Princeton,IN 47670-
Ciry'. Stare, ann ZIPCade Ciry, Srare. and ZIP Code
Emnil Tde honeNumAer F.-moil
Under penaltles of perjury, 1 hereby certify that this Sales Disclosure, to [he best of my knowledge and belief, is true, mrrect
and comple[e as requ//ir w, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure AcC.
�� /i .�a.� /v -�2 / 'L
� namreoj (ler SignamreaJSeller
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.BUYERS GRANT S -APPGICATIONFOR�PROPERTYTAX�DEDUCTIONS-iDE�`TIFYALLITEMSTHATAPPLY��� - �
LaCurtis Tabom
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ry
A dres(.VUmDsondS[reet) Address(NUmberand5vert)
Princetan, IN 47670.
Grv, Smtq andZlG Qde Ciry•, Smn, and Z1PCOde
E-moil Telr /roneNumber E'-mall
THESALESDIXLOSUREFORMMAI'BEUSEDTUAPPLI'FORCE0.TAI,YDEDURIONSFORTNI .I�ENfIFYALLO HATAPPLY'.
YES NO COXDITION YFS AO C0401TIOY
�x � 1. \Nill [his property be the buyer's primary ❑X ❑ 3. Homestead
residence? Provide mmplete address of pri ary � � g. Solar Ener ' g/Cooling Syscem
residence, including county:
2108 S. MAIN STREET . Wind Power Device
Address(NUmbercnd5vee[) ❑ Q 6. Hydroelectric Power Device
Princeton, IN a7670 GIBSON � � 7, Geothermal Energy Heating/Cooling Device
G9t Smre ZIP Code Counry
��] 2. Does the buyer have a homestead in Indiana ro be � 0 8. Is this property a residential rental property?
vawied for this residence? If yes, pro�ide ❑ Q 9. 4Vould you like to receive tax statements for this
complere address of residence being ��acated, property via e-mail? (Provide contact in%rmotion
including rounty: beloxe Please see instructions for more informadon.
Not ovailable in olf rounties.)
Addres(NumbvandStmtJ � � /� —/�+ �� � �� OO� . � �'O�^
0
Ciry•, Smte ZIP [ode Cvunq•
Primorvpmperry owner mnruc[ name E-mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correc[
aod comple[e as required by law, and is prepared in accordance wi[h IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Securit}• and Driver's License/Other numbers are no[ necessary if no Homes[ead Deducdon is
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Lastidigi6ofBuyerlDriveri Sro[e LastSDigltto�5ada15ecuriroNumber !as[SdigiGSOfBuyer2/SpouseDriveh S[a[e LastiDigi6o%Social5ecuriry
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