Homestead_Hileman INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Laura Rininger Closing Coordinator
Preporer of the Sales Disclosure Form Title
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
"E ELLER(S)/GRANEOIt(g)ID .-i, 11 21:1%7.7. i; n -ems 7 :.F
Denny R. Dodd Jayne 1 Dodd
Seller I-Name as aypea�conveyance document Seller 2-Name as appears on conveyance document
�jo f/ �12-e—ieso,J i>10 i1 . � E_ Ca.I Si
Address Number and Street t , �/ .r� liras(Number and Street) /\
lc7 Y/ 4/S' 1N 7 Z' tR 40,-..r—r)ea t� 'U-6 (r� LC�ccl [,-
Under penalties of perjury,I hereby certify that this Sales Disclosure,to -he best of my knowledge and belief,is true,correct
and complete as requi d by law,and is prepared in accordance wi I 6-1.1-5.5,"R Property Sales Disclosure Act".
�(gnature ofSeller - 0 attire ofVler
Penny H florid I (• IS -jb Jaynet Dodd 1t S.' (6
Printed Name of Seller Sign Date(MM/DD/YYI.1) Printed Name of Seller Sign Date(MM/00/YYYI)_
�F4B UYER(S)%GRAN�TE6(S);_AP,PLICATI ON1F,OR,PRORERTIY±T$MBIiCTI(liq ENT1aAfthif E1,1S(THATI%AP,PL'Yr ■ _
LuCas E. Hileman Rachael N. Hileman
Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance document
239E750S 239E750S
Address(Number and Street) Address(Number and Street)
Ft. Branch,IN 47648 Ft. Branch. IN 47648
�L
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead NOV 17 LO16
residence? Provide complete address of primary ❑ fl 4.Solar Energy Heati /Cooling S to
residence,including county: ❑ 0 S.Wind Power DevipAt
7860 S 10 E r p�r�rl r� TY AUDITOR
Address(Number and Street) ❑ 6. HydroelecfRPItglMrCIZA�
Ft. Branch, IN 47648 Gibson ❑ Pi 7.Geothermal Energy Heating/Cooling Device
City.State ZIP Code County
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
E
vacated for this residence? If yes,provide ❑ 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)
CCity,State ZlPlode County O1 C L _ IR 49 -010 3 - 06 ` -5n-O 6
Primary property owner contact name E-mail