Homestead_Henry INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
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 CHRISTINAOREGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
E.SELLERS)/GRANTOR(S)
David I Cutsinger Ludy K Cutsinger
.Sellerl-r-Nameasap rs on conveyance document n Seller T‘A'ame as appears on conveyance document
8
)''yggd (Numbera dStreet)'� rAddres(Numberand Street)
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and.complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Signature of Seller gnature eller O J o
• '• 'r•- .
• �..e Judy K Cutsinger
Printed Name of Seller Sian Date(M.M/DD/YYYY) Printed Name of Seller Sign Date(MM/UD/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATIO 'OR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Richard D. Henry Rachael C. Henry
Buyer.l-Name asappeorsnveyance document Buyer?Nameas appears on conveyance documentf .
L j s •.- vv sL (X): fld aC;fn St-
�Address(A'umbber nd
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TF(%E�P
Pire.c ", Ne<tSCoNDrf N -•' I--Ye.s7C o?,vcoNDmou .3we>v OA,T%."
>r❑ 1
residence?l this r Provide come buyer's primary s o imar I�❑ 3.Homestead yA00/TO
P primary n 0 4.Solar Energy Heating/Cooling System R
residence,including county: ❑
S.Wind Power Device
1818 Cottonwood Dr
Address(Number and Street) ❑ 151 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ N 7.Geothermal Energy Heating/Cooling Device
City tate ZlPCode County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 B.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ J 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.
�0 ��a1 ST
Not available in all counties.)
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Address(Number and Street)
Ut>,rea5L: 1ij.1 J,,f �t�(DVS �tk0,1 -/0,7-o‘-6770 Doi.a76 -.M?
City,State ZIP Code County
Primary property owner contact name E-mail