Homestead_Trible •
INDIANA SALES DISCLOSURE FORM SDF ID:__ - Page 2
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555
City,Stare,and ZIP Code Telephone Number E-mail
'E.-,SELLER(S)/GRANTOR(S)'—' _ • -- - -
Frma.l Courtney
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
1345 Carousel Ct
Address(Number and Street) Address(Number and Street)
Evansville IN 47715 _
Telephone Number 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".
nature of5eller ✓ eY Signature of Seller
Frma.I Courtney 8/13/2013
Printed Name of Seller Sian Date(MM/0D/YYn Printed Name of Seller Sian Date(MM/DD/MTI
-F..BUYER(S , ANNTTEE(S)=_APPLIGATION•FOR-PROPERTY TAX..DEDUCTIONS=,IDENTIFY ALL ITEMSTHATAPPLY__
7.6aron R.Trible
.. „ rs on conveyance document Buyer 2-Name as appears on conveyance document
16138 SR 136E
Address(Number and Street) Address(Number and Street)
Robards, KY 42452
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 NO CONDITION
Q ❑ 1.Will this property be the buyer's primary 1 ❑ 3. Home ��""''�� �
residence? Provide complete address of primary ❑ u 4.Solar Energy Heat Copli Sy �m D
residence,including county: ❑ 0 5.Wind Power Devic ��
523 S 8th Ave
Address(Number and Street) ❑ 0 6.Hydroelectric Power DevAQ5G 19 2013
Haubstadt, IN 47639 Gibson ❑ 0 7,Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residen�j(ren�111101 ?
vacated for this residence? If yes,provide ❑ 0 9.Would you like to receiv_ at. -
gel Alta t
complete address of residence being vacated, property via e-ma? t Pti- c.ntact information
including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
dG-
City.State ZIP Code County
01.E- 06 -ofa- ago. 291- cv7
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 filed.)
Signature of Buyer1 Signature of Buyer2/spouse
Sharon R Trible 8/13/2013
Number License/ID/Other Number