Homestead_Vieck INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
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 E-mail
a.SELLER(S)JGRANTOR(S) - • -
Melanie G (Wagner)Davis
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
409 Lincoln St
Address(Number and Street) Address(Number and Street)
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".
Signaat of Seller / Signature of Seller
Melanie G Davis ///f f7d Co
Printed Name of Seller Sian Date(MM/DO/YYYfl Printed Name ofSeller Sian Date(MM/DO/YYYY)
F:BUYERS)/GRANTEE(S) APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY-ALL` PHb1t' fAT ,,- -
atrick J.Vieck
AA66--ii TT I I
Buyer I'Name asap pears on conveyance document Buyer 2-Name as appears on conveyance document -
53625 St.Thomas Rd. NOV 3 7016 --
Address(Number and Street) Address(Number and Sweet)
Vincennes, IN 47591 //jj�
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I Y6 . CONDITION
Fl ❑ 1.Will this property be the buyer's primary 4 0 ❑ 3.Homestead
residence? Provide complete address of primary . MI 4. Solar Energy Heating/Cooling System
residence,including county: ❑
409 Lincoln St 5.Wind Power Device
Address(Number and Street) ❑ Fl 6. Hydroelectric Power Device
- Princeton, IN 47670 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City tate ZIP Code County
[jai2.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 ❑ Fl 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.
S/a ?z S. Si, -77,004a s fc).
A dress(Number and Street)
ncenne5 2n1 '-/75-9 / Knax A& -!d - d7- 103 -goo . o 3S-a 3.8
City,State ZIP Code Coun
A 6.,..,r i,..,vw7•-even ranrnct name .ail