Homestead_Sullivan INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Laura Rininger Closing Coordinator •
Preporer 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 Email
lE SEElEER(S)%GE.AN,T,OR(S) ":".: ,i ce o —T-__. T ^^af%=o'! X7�" f` 't'IT7'� , Sr m-�s- -T-7"iT17
Brian R Stout Melinda J Stout
Seller I-Name as appears on conveyance document Seller 2'Name as appears on conveyance document
PO Rox 3004 PO Box 3004
Address(Number and Street) Address(Number and Street)
San Ramon CA 94583
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a d complete as r:(jt ire' by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
n -1�2ter&a.:L ,JCthe_S ,f-
Si reo Seller Signature of SOW. /
Brian R Stout L-�y4.(� Melinda J Stout 5te�/1p
Printed Name of Seller Sio to t/DO/YYYY) Printed Name of Seller Sign 515)111°
Printed /DD/YYYI')
iEAU,YER(S)y/NRANTEE(S)t,LAPP,iteATioNfEeR1IM P.ERTIY6TAX vDEDUCTIONSFIIDENT1EWALLrtITEMS THATMFIRI:Yt ` -.1
Laura A. Sullivan Ronald J. Roy
Buyer 1.Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
Log /4 e /)i z r/Y E n �,+/�1 ' 7 e ( -/Y /Cd.
Address(Numberf and Street) Address(Number and Street)
Itnrefin Z�. (l74 VV kitI
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE MA - • c ,•
YES NO CONDITION YES NO CONDITION .COG I f6
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead 49, 35:-
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Coolin65stem
residence,including county: ❑ 0 5.Wind Power Device �/O
1897 F Warrenton Rd .Q
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Haubstadt. IN 47639 Gibson
111 Q 7.Geothermal Energy Heating/Cooling Device
Ci ,State ZIP Code County N.
r2. Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property?
vacated for this residence? If yes,provide T-FA 9.Would you like to receive tax statements for this
complete address of residence being vacataU,50.- t 3t Vt property via e-mail?(Provide contact information
including county: \\\ - below. Please see instructions for more information.
(4;04 1?) e(rn r/ Y Pre. Not available in all counties.)
Address(Number and Street)
Mille 210I . tri, Li1(n90 0Z-al 37' -J - OW. 7‘a -001
City,State ZIP Code County
Primary property owner contact name E-mail