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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.
Christa Kingsbury Closing Manager
Preparer of the Sales Disclosure Form Title
501 Main Street Bosse Title
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000
City,State,and ZIP Code Telephone Number E-mail
E(SELIERISIZGRANTORIS)1,,,D,..e.,41-7-71'7,
Steven I intrenich lennifer I intzenich
Seller 1 Name as appears on conveyance document Seller 2-Nome as appears on conveyance document
6765 S 600 W 6765 S 600 W
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a21.compl. t requi ed by law,and is prepared in accordance-with IC 6-1.1 5.5,"R,a Pr erty Spies Dijclosure Act".
)L/. -7 , I - -Alt A .t—a
—Signe f Se • • I n•cure of silt-
• l
Steven!int7enirh 03/18/13 LANn-2e1'3 14- 03/18/13
Printed Name of Seller Sign Date(14M/DEI/EYYY) Printed Name of Seller Sign Date(MNIDDM7T)
•P;,BUYER(MGRANTEE(SjrAP,P,LIGATIONIF,ORVPROPERTYsTAX+DEOUGTIONSHIDENT ",1 .
Jennifer LintzeniCh
Buyer I-Name as appears on conveyance document Buyer 2-Name as ap n c .
6765 S 600 W
Address(Number and Street) Address(Number and Street) MAR 2 8;L 013
Owensville IN 47665
Telephone Number GIBSON COUNTY AUDITOR E-mail -
THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
Fl LI 1.Will this property be the buyer's primary 12 LI 3.Homestead
residence? Provide complete address of primary J ig 4.Solar Energy Heating/Cooling System
residence,including county:
15I 5.Wind Power Device
6765 5 600 W
Address(Number and Street) LI Fl 6.Hydroelectric Power Device
Owensville IN 47665 • Gibson LI 12 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
LI8.Is this property a residential rental property?
Fl 2.Does the buyer have a homestead in Indiana to be 12
vacated for this residence? If yes,provide LI Fl 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
- )oo - C13' . soi-0.2.■
City,State ZIPCede County
Primary property owner contact name E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to 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 Disclosure Act".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
-lug filed.
tin A.1111L
ens; =real B ci 111 Signature of Buyer2/Spouse
lennifer I I int7enich 03/18/13
Number License/ID/Other Number