Homestead_Sundlerland •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
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
E.SELLER(S)/GRANTOR(S) •
Michael L Stnrmnnt
Seller I•Name as appears on conveyance document Seller 2-Name as appears on conveyance document
449 E 795 S
Address(Number and Street) Address(Number and Street)
Ft Branch IN 47648
Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required_(�b�ylaw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Michael I Stnrmnnt 10/17/2014 i r
Printed Name of Seller Sign Date(MM/DD/YYY1) Printed Name of Seller 1 : '•n D% , DD/YYY1)
F.BU�ER(S3/G ANIEE S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITE ' -TSA'C' tPL{'�:/ I 1 _
h wn M. n.-d-n•
• • ... • • conveyance document Buyer 2-Name as appears on conveyancedocurij,i5 I 2I 2014
7841 S.Andee Lane
Address(Number and Street) Address(Number and Street) ///1�
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES ....,.. •
0 ❑ 1.Will this property be the buyer's primary Ti ❑ 3.`Homestead
residence? Provide complete address of primary U 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
449E 795 S 5.Wind Power Device
Address(Number and Street) ❑ ri 6.Hydroelectric Power Device
Ft. Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ IN 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 ❑ IN 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)
A (a - l9-/ 9 - °toy -00 /. 33o - o24
Ciry.State ZIPCade County
Primary property owner con tact name E-mail