Homestead_Davis (34)Laura Rininaer
Preparer o/the Sala D"uNosvre Folm
7820 Eaale Cresi Bivd Ste 201
Addrets (Num6er and Svee[J
Evansville. IN 47715
City.Sm[q and ZIPCode
Seller I- Name as appears an canveyance dxvmen[
2068 E SR 64
Addrm (Number and SVmtJ
Ciry, SmtG and LP Code
Tide
teaional Title Services.
I.t_ _ '_ _.' "o '_
Seller 2- Name as appmrs on
Address (Num6er and Strrel)
Ciry, Sm[e, and ZIPCOde
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is
an�i complete�as required by law� and is prepared in accordance with IC 6d.1-S.S, "Real Property Sales Disclosi
Lance R Davis
Buyo I� Nume as appears on mmeyonre dxvmm[
807 S Stout St.
Address (Number und Stree[J
Princeton IN 47670
Ciry.Smtt and LPCode
SignaNre
6uyer } - Name as appevrs
Address(Num6e�andSVee[J A'0�
/y
THE SALFS UISCLOSURE FORM FL1Y 9E USED TO APPLY FOR CERTAI\ DEDURIOYS FOR 7'HIS PROPER7Y. IDENTIFY ALL OF THOSE
Q✓ � 1. Will [his property be Che buyer's primary
residence? Provide comple[e address of �
residence, including county:
2068 E SR 64
Addros (A'um6erand5trret)
Princeton.IN 47670 _ Gibson
City. S[ate ZIPCOde Caunry
� Q 2. Does the buyer have a homestead in Indiana to be
vacated for [his residence? tf yes, provide
complete address of residence being vacated,
including county:
Addrect (NUmber
[iry. Smle ZIPCOde Counry
�❑ ❑ 3. ti
ie, corret[
Act".
�. Solar Energy Heating/Cooling Systei
� Q 5. Wind Power Device
� Q 6. Hydroelectric Power Device
❑ Q✓ 7. Geothermal Energy Heating/Coolmg Device
� Q 8. Is this proper[y a residential ren[al proper[y?
� Q 9. Would you like to receive tax statements for this
proper[y via e-mail? (Provide contact in�ormation
below. Please see ins[ructions%r more informa[ion.
Not available in all roundes.)
�-Ia-ICo-Ic�I-000 .5'a�,�a?_
Under penal[ies of perjury, 1 hereby certify that [his Sales Disclosure, [o [he best of my knowledge and belief,
and complete as required by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Discic
Spouse informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead I
be�ng k�d.)
�i��/vi ��� �--� I
SignntureafBuyerl i � SignamreofBuyer2/Spovse
E-mall
[rue, correct
re Act". (No[e:
duction is
%
Las[Sdigi[so(Buyer2/SpouseDrivefs Sm[e LastSDiqirso(SocialSecurii
Liceue/ID/OtherNum6er Num6er License/10/OtherNum6er �