Homestead_Chaplin INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:PREPARER
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,State,and ZIP Cade Telephone Number
Small
:E.SELLER(S)/GRANTOR(S)'• __._. --- - - --` - - - = - --- - - - - _ . ---- . -'
Dean I I uchini Jeanette L I uchini
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
409 Bradley Or 409 Bradley Or
Address(Number and Street) Address(Number and Street)
Hauhstadt IN 47619 Haubstadt IN 47639
der •enalti-: • • . .-r , I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an• co pl- r • ed •y law,and is prepared in accordance,wit h�t IC 6-1, - .5,"•QaliPro e-rty Sales Disclosure Act".
Signature of Seller -Signat�u a of Seller
Dean I I uchini 8/4/7014 a tte L Luchini 8/4/2014
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/OD/Mr
:I.• R(S) - '. NTEE[S);-APPLICATIONFORPROPER TYTAX,DEDUCTIONS=IDENTIFY.A LL ITEMS THAT APPLY_ __
Joel M.Chaplin tacia L.Chaplin
Buyer l•••- ,s appears on conveyance document r2-Name as ars on conveyance document
\
243 Hedgerow Dr. 24.3 He gerow Dr.
Address(Number and Street) Address(Number and Street)
Chambersubrq, PA 17202 Chambersubrg, PA 17202
ED
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPER • ' . • HOSE THAT AP 1'l
IAl
YES NO CONDITION I NO CONDITION
0 ❑ 1.Will this property be the buyer's primary P2 I ---• •••• •:• AUG 6 2014
residence? Provide complete address of primary ❑ 12 4.Solar Energy Heating/Cooling System
residence,including county: ❑
409 Bradley Dr 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Poterra �a°•,"UNTS Q'1M
Haubstadt. IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating oo lug a ITOR
City,State ZIP Code County
❑ 12 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 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)
01G n?3-ct. -/v/- ate. Ghe. co 9
City State ZIP Code County
Primary property owner contact name Email