Homestead_Johnson (19) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Samantha Cutsinger
Preparer of the Sales Disclosure Form Title
226 W. Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 samantha.btemw.twcbc.com
City.State and ZIP Code Telephone Number E-mail
i.Ei:SEELEKSTIGRANTOR(SrLa e.,,:4;...7-2 4..-•r-.4 .1 c-z.77..-,..;J.:.:7, t-. :.zu.:17:
The Troy M and Virginia C I and I iv Tr by Regions Rank Sue Tr
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10450 I incoln Trail
Address(Number and Street) Address(Number and Street)
Fairview Heights II 62708
.
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,iitrue,correct
wid complete as require reauiresi 14law n • epared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller Signature of Seller
Ryan Reifschneider for Regions Bank Sue Ti
Printed Name of Seller Sian Date Waren Printed Name 0/Seller Sign Dote(M4/DDIYITY)
EFTBUYE R(91/6 RA WEE ISW-_-±ApPITIEATIO NO WP ITO e E RTillt-TAX,D E DU OTI 0 N Sil DENTI FIVALLitTEMSITHAVAPP,EY .:_a--. - 7-7.-7"...
Janet I. Johnson
9
Buyer I-Name as appears on conveyance document Buyer Z-Name as appears on conveyFOIL ,
3 ,
10014 Petersburg Rd. E -
Address(Number and Street) Address(Number and Street)
Evansville,IN 47725 FEB 2 9 Z016
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF
GI/1380t411301AITY AUDITOR
YES NO CONDITION YES NO CONDITION
g 0 1.Will this property be the buyer's primary g g 3.Homestead
residence? Provide complete address of primary 0 0 4.Solar Energy Heating/Cooling System
residence,including county:
g NI 5.Wind Power Device
2001E I ake Rd
Address(Number and Street) 0 0 6.Hydroelectric Power Device
Princeton,IN 47670 Gibson 0 Z 7.Geothermal Energy Heating/Cooling Device
City State ZIP Code County
0 NI 8.Is this property a residential rental property?
g g 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide 9 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.
10014 Petersburg Rd. Not available in all counties.)
Address(Number and Street)
Evansville, IN 47725 Vandenburgh as -t a-o 8- Llo 1 - WI .569 -oaF
City,State ZIP Code County
Primary property owner contact name E-mail