Homestead_Lantrip INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D P,REPARER . i & J• _7 Y ,_s _ «_ ..!,;,-...:±j.:_ :. _y r. -. ti C SL._
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE, IN 47715 812-402-4553 CHRISTINA(oREGIONAL-LT.COM
City.State,and ZIP Code Telephone Number E-mail
:E SELL•ER(S)/GRANTOR(S)_. ..Y-. , _ _ ,.4 — _'.`" -' .T - :_ <:1
Robert G Stalling
Seller 1.liame as appears on conveyance document Seller 2-Name as appears on conveyance document
X 1 F Yh o n roe
A um— 7a,dS1re¢t)C� Address(Number and Street)
X' \rc�k°n
Und penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an. , p plete a re uir y I w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�_ e1_- � t'�\
S:5natureolS er \ ((������ / Signature of Seller
Robert G Stelling ) V1P/ 1�Z016
Printed Name of Seller �GSIan o(MM/DD/YIYY) Printed Name of Seller Sian Date(M,N/DD/YYYf
,F.BUYER(S)/GRANTEE(S):APPLICAT10N;FOR8P:ROPERTY:TAXTEDUCTIONSEIDENTIF,Y i .IpEI-s,THATAPPLY;_;__ ,, �- -
Jennifer L.Lenin° . fi '.%
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyanredoffinient,v i,
X �5 1,d v hn e Ste. - ,
CAdio(N�lier a=tr'eet= 1 � Address(Number and Street) �Iti 2 4
(� � 5-;-) G C_.J
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,THE SALESOISCLOSURE FORMMAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS P:e'ER • _ i1Q)`'ALYOPTHOSE.THAT APPLY.
YES / NO CONDITION iYES NOS CONDITION:71
5 ❑ 1.Will this property be the buyer's primary K ❑ 3.Home -.• J
residence? Provide complete address of primar• r CI 4.Solar Energy Heating/Cooling System
residence,including county:
227 E Monroe St ❑ 0- 5.Wind Power Device
Address(Number and Street) ❑ fi 6.Hydroelectric Power Device
Princeton, IN 47670 _ _ _ Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 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 n 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) ac _I a. •x 57_4 c' tot• 1�,-on
City,State ZIP Code County \N^ f- —-- `�J (��
Primary property owner contact name E-mail
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