Homestead_Moore (10) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.FREPARER_
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,State,and ZIP Code Telephone Number
E-mail
:EC.SELI:ER(S)/GRRNTOR(S) --l_----- - . ,t,,,-Q., .—. `_—,-- _ —_--_--
Tyler W Me.Flihiney Cortni S MrEllhiney
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
324 W Pine St 324 W Pine St
Address(Number and Street) Address(Number and Street)
Princeton IN 47670 Princeton IN 47670
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,"Real Property Sales Disclosure Act".
7,4 J C ),`
Signature f / _///rf3 signaturea&eller —/� /3
Tyler W MrEllhiney t/Y" -(I(, Cortni S MrEllhiney
Printed Name of Seller Sian Date(MM/OD/MY) Printed Name at Seller S)11/1"-/
an Date(MM/OD/YYrn
F:BUYER(S)/GRANT EE(S)t-:APPLICATION,FOR.PROPERTY TAX•DEDUCTIONS=IDENTIFY ALL ITEMS THAT APPLY __.
Anita S. Moore
Buyer I-Nome os appears on conveyance document Buyer 2-Name as appears on conveyance document
527 N.Pear St.
Address(Number and Street) Address(Number and Street)
ML Carmel. IL 62863 —
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
ig ❑ 1.Will this property be the buyer's primary 1
p p ty y p ry 0 ❑ 3.Homestead y �-•r
residence? Provide complete address of primary ❑ 0 4.Solar Energy eat / i s em
residence,including county: ❑
324 W Pine St S.Wind Power Device����UU,,�� $ 2013
Address(Number and Street) ❑ 0 6.Hydroelectric PoweIIWDv e
Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy eating/ oo 'I a ti- •Ice
City,State ZIP Code County I 11
❑ 0 8.Is this property a r-.,t, 1,ia�rrft.. propel(
❑ 0 2.Does the buyer have a homestead in Indiana to be 1��1 TTppKK
vacated for this residence? If yes,provide ❑ 0 9.Would you I(})(ggOtJcGQ� tat}nPntsTor this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below. Please see instructions for more information.
G(y!`fN Not available in all counties.)
Address(Number and Street) cg6 — la-o 1— tot -W3. 361- `{O/
City,State ZIP Code 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
being file
Alt -NJ ` /irn-i-t —/L/—i3
Signature of Buyer! Signature ofBuyer2/Spause
Anita S Moore
Number License/ID/Other Number