HomeMy WebLinkAboutHomestead_Smith (73) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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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 Code Telephone Number E-mail
!Et SELLER(5)/GRANTOR(Sill _ =
Janice K McGillem
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
510 S Strait St
Address(Number and Street) Address(Number and Street)
Princeton IN 47670
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".
�Ctk 1< 1V\ ,f� lLti,
Slgdature of Seller Signature of Seller
-�' • . �e__,.._• 12/17/2014
P -..Name of Seller Sign Date(M.N/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYI)
IF IUYER(S)%GRAN. E(Sja.APPLICATION FOR.RROPERTtY_TAXDEDUGTIONS,e_IDENTIFY,ALL.ITEMSTHATAPPLY _ _ j
Karen A. Smith
:u.er I-Name,...pears on conveyance document Buyer 2-Name as appears an conveyance document
302 Address N. Kelsey Ave. PI
Add (Number and Street) Address(Number and Street) t
YES NO CONDITION Y NO CONDITION
GIBSnN Cou.tom/
n 1.Will this property be the buyer's primary 0 ❑ 3. Homestead NTyA.
residence? Provide complete address of primary nr Heating/Cooling System to,
residence,including county: ❑
5.Wind Power Device
5105 Stout St
Address(Number and Street) ❑ 0 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson
7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Q ❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 B• Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 15I 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.
302 N. Kelsey Ave.
Not available in I1 counties.)
Address(Number and Street)
Evansville, IN 47711 Vandenburgh _1°7_o 2 0-1UOJoi-O/ Jog?
City,State ZIP Code County
Primary property owner contact name E-mail