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Homestead_Vaughn INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 'I)!.PREPARER�' ---'7717- L - - - —_ Laura Rininger Closing Coordinator Preparer of the Sales Disclosure Form Title • 7820 Eagle Crest Blvd Ste 201 Regional Title Services,LLC Address(Number and Sheet) Company Evansville, IN 47715 812-759-5555 City,State,and ZIP Code Telephone Number E-mail bSEUER(S)`/.GRANTOR(STF t. :-_. _ _ .,,. -.--- -- -' Danny Ray Smitha Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 101 S Willard St Address(Number and Street) Address(Number and Street) Ft Branch IN 47648 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and cpnplete as required by law,and ' e repared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". �j a __torso Signature of S;-r / Signature of Seller Danny Rey Smitha 717/2015 Printed Name of Seller Sian Date(M.M/DD/YYY1) Printed Name of Seller Sian Date(MM/oopYYt) Fr,BUYERTST/GRANEE(S)i APP LICATIONIEOR%FROPERTYrTAX;DEDUCTI0N5zIDENTIr ALE ITEMSLT T'A _ +t 1 Calvin Bo Vaughn BuyerI Name as appears on conveyance document Buyer 2-Name as appears on conveyance documer „ 2130 Vine Ct.Aot.34 B Q /'s Address(Number and Street) Address(Number and Street) 2p/ Princeton, IN 47670 0'/QS YES NO CONDITION YES NO CONDITION Q ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System residence,including county: ❑ ig 101 S Willard St. S.Wind Power Device Address(Number and Street) ❑ 12 6.Hydroelectric Power Device FL Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code - County ❑ 0 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) - 303 -000.4/ 7-0016 City,State ZIP Code County Primary property owner contact name E-mail