Homestead_McCammon INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER - - _ _. .._
Laura Rininger Closing Coordinator
Preparer of the Sala 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
E.SELLER(S)/GRANTOR(S)- - ._ _ . - _
Robed F Fried
Seller I-Name as appears on conveyance document Seller 2-Name as appean on conveyance document
't
PO Box 446 1 5`
Address(Number and Street) Address(Number and Street)
Corydon IN 47112
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co.. y t= .s re;' ' -pared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Sig -rare of Seller Signature of Seller
Robert E Fried 1/16/2015
Printed Name o(Seller Sign Date(MM/D(WM) Printed Name of Seller Si•a Date MM/DDS/
-F.BUYER S GRANTEE S ,-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS 11� Y. i . !ak. _
Carah E.McCammon Shawn A. MCCammon I - ,,.
Buyer I-Name as appears on conveyance document Buyer 1-Name as appears on conveyance document
108 KeneiDo Rd. 108 Keneioo Rd. JAN 2 0 2015
Address(Number and Street) Address(Number and Street)
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 NO CONDITION
N ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
6577 W 450 S 5.Wind Power Device
Address(Number and Street) ❑ N 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson
N 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code- County
❑ A 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.
• • •al a. a in a coun Ies.
Address(Number and Street)
a6 - / 7 - 0/- a o0 -000. 578-oz/
City,State ZIP Code Cour(ry
e -mail