Homestead_Schupp INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - -
Laura Rininoer Closing Coordinator
Preparer of the Sales Disclosure Form. Tule
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
•
E.SELLER(S)/GRANTOR(S)
-
Joshua P Burke
Setter i-Name as appears or conveyance document Seller 2-Name as appears on conveyance document
57131 incnln Ave
Address(Number and Seeet) 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
and corn, Ip eye as req ired by I v,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
SE .storeu((SSelllleerr Signature of Seller
Joshua P. Burke 8/2612014
Printed Name of Seller Sian Date 1MM/DD/Ittll Printed Name of Seller Son Date(1W/DDntttl
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Kelli L. Schuop
Buver 1-Name as appears on conveyance document Sayer 2-Name as appears un conveyance document
7231 Pinehurst Dr.
Address(Number and Street) Address(Number and Street)
Evansville, IN 47711
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 P.J 5
❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead Ap pL/. g /-�-y
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heatingg/CR o Un System
residence,including county: ❑ AUb 8 20t4
Is
107 Ben St S.Wind Power Device
Address(Number and Street) ❑ ig 6. Hydroelectric Power r/p(evice
Haubstadt. IN 47639 Gibson ❑ &I 7.Geothermal Energyi "dLi o 0, 'a Device
Cin',State ZIP Code County 1 c
❑ 2.Does the buyer have a homestead in Indiana to be ❑ SI 8.Is this propel'Pa'14t4(1;20 yid }bbRy?
vacated for this residence? If yes,provide ❑ si 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) to ^ ce s-1--&s 9
Cin•,Scare ZIP Code County _I '�� 1/NR yv7Y�(J `('�Jr�`/�t/
Primary propersy owner contact name E-mail