Homestead_Lancaster INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -- . . --- - - - -^ _- - - - - -` • -.
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINA @REGIONAL-LT.COM
Ciry,State,and ZIPCode Telephone Number E-mail
E.`SELLER(S)/GRANTOR(S) __. . _..•L ----- -- . - ------ - -- - - - —..._
Jerry L Grubb Rhonda G Gmbh
Seller lsjame as appears on conveyy;cf docurpenr/ Seller 2-Name as appears on conveyance document
X�e-4/9V a� 0“4 b !� /0 3 i(•-7 I 5 o S
Address(Number an trees) Address(Number and Street)
X / 03678. osos . CALM-AP) 0117 .r 976cCc0
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and ' p to as required b aw an Is pre to cordance with IC 6-1.1-5.5,"Re 1 Prop rty Sales osure Act".
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'Signora -of Seller-, Signature of Seller
Jerry L Grubb Xs 7 ;.27-00y, 'Rhonda Grubb 5-a7-r�.C%I'(
Printed Name of Seller Sian Dare(MM YY) I/DD/YY Printed Name of Seller Sian Date C101/DO/YYYYI
F.BUYERW/GRANTEE(S)__APPLICATION FOR PROPERTY TAX DEDUCTIONS=-IDENTIFY ALL ITEMS THAT APPLY__ ,_____ -
Ian C. Lancaster Amber L. Lancaster
Buyer l-Name as appea an conveyance document Buyer 2-Name as appears on conveyance document
/tress A( .A.0.4L �t 51,1. N /vO;A , -'
Address(Number and 5'eet) _ Address(Number and Street)
X __( • 1k ' e. Ov€7\sv:Ut1 Xw H76-65
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THE SALES DISCLOSURE FOR.I MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES CONDITION YES/NO CONDITION JUN 9' 2014 I
evyiir
1.Will this property be the buyer's primary ❑ 3. Homestead residence? Provide complete address of primary ❑ 0 4.Solar Energy H:G�•'ng/C:,'li
esidence,including county: 1+ gr71^j;
f()? ❑ 5.Wind P@#TteB� OlJNT.Y AUDITOR
Ads(Num erands eer]-„ �—; r /' ❑ N 6.Hydroelectric Power evlce
Y�0,1\�( „ k-t 4si LL7`Y(.03lrtt:1r.
t t1 ❑ Q 7.Geothermal Energy Heating/Cooling Device
City, to ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ N 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.
3 (a N VNt\cc i 1..7,. 240-13 Not available in all counties.)
Addr (Number and Stree /� - Z �p . 200 Co f Z �'7 �� /
t� 4\ec A� y0 u1l(clfi j G t�3Jb i1 Ian C.Lancaster ! to
City,State ZIP Code County
Primary property owner contact name E-mail