Homestead_Bulens INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
:D !PREPARER -- —1 -- . ti .; - .-4t r%72. °�T F., "`4`::
Becky King . Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd..Ste 201 _-Regional Title Services
Address(Number and Street) Company
•
Evansville. IN 47715 812-759-5555 beckv.kinga@regionaltitleilc.com
City,State,and ZIP Code Telephone Number E-mail
SEE:SELLER(S)/GkA N,T.OR(S) . 7Z- '`c, _ . ` f — "` 7.1.7c.,1:7- --
I isa M MrEllhiney -
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
114 N Stout 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
a4i7
complete has required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
�otSeller°- `\
Signature of Seller
I isa M MrFllhiney V 07/12/2016
Printed Name of Seller Sion Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY)
_FyBU,YER(S)°/GRANTEE(Sfi.APP,LIGATIONIF,ORIP, ORERTY±TAX;DEDUCTIONS`_11DENTIFY:ALGITEMS(THATt'APPL•YJ 7.71,_ '
Keshia M Bulens lanis C F Bulens
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document jr H •�_�
626 E State St. same QQQQ ( ••>
Address(Number and Street) Address(Number and Street) �j
Princeton, IN 47670 -
THE 5 ES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT
CONDITION YES O ,CONDITION /1
❑ (1.Will this property be the buyer's primary YES
(3,LlevlOmestead I/(/TO residence? Provide complete address of primary ❑ Solar Energy Heating/Cooling System
'residence,including county: ❑ .
p 5.Wind Power Device
Address(Number and Street) ❑ 151 6. Hydroelectric Power Device
City,State ZIP de caanty ❑ Fl 7.Geothermal Energy Heating/Cooling Device
I k ❑ ig 8. Is this property a residential rental property?
❑ i 2. Does the buyer have a homestead in Indiana to be
t� vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
" omplete 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)
City,State ZIP Code County (9(0 -D -ao y -(�02 DI �ba
Primary property owner contact name E-mail