Homestead_Greenley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
'.D:PREPARER!,- __. 7 i ',L. - ..,_ , ° 71...=.7;:::::_ - s12„, - =-
Britany Barnes Title Support
Preparer of the Sales Disclosure Form Title
226 W Broadway Broadway Title, Inc.
Address(Number and Street) Company
Princeton, IN 47670 812-386-1687 britany.bti @mw,twcbc.com
City,State,and ZIP Code Telephone Number E-mail
'E.SELEER(S)/GRANTOR(S)- -.' ' ? z: ..1." " .t.: . il.. - _ - .c. ':--
Samantha L.Cutsinger
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
639 E Water St
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
ipicomplete as req iris b •law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
AY Ait dr A■ AL �.
Signata •o Seller , Signature of Seller
Samantha L.Cutsinger —9 7 6
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller 25n Date(MM/DD/VYY)
P.BUYER(S)/GRANTEE(S).SAPPLICATIONT ORPROP.ERTMAX'DEDUCTIONSAIDENTIE ALLITEMS',THATAPPLY=- - • .
Justin V Greenley Leslie A.Greenley ED
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyaFocueenL 9�j�'j
2739 Hartmetz Ave 2739 Hartmetz Ave ��ggLL
Address(Number and Street) Address(Number and Street)
Evansville, IN 47712 Evansville, IN 47712 JUN 10 2016
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE/
lbStriODUNTY AUDITOR
YES NO CONDITION I YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary ❑ IS 4.Solar Energy Heating/Cooling System
residence,including county: ❑ tg 5.Wind Power Device
639 E Water St
Address(Number and Street) _, ❑ 12 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 12 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ (2 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)
a(I'. ja-D?- yoa - -D3sda
City,State ZIP Code County
Primary property owner contact name E-mail