Homestead_McGill (2) INDIANA SALES DISCLOSURE FORM SDF ID: .
Page 2
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Laura Rininger Closing Coordinator
Prepare:of the Salm Disclosure Form Title
7820 Eaate Crest Blvd Ste 201 Regional Title Services.LLC
Address(Thenber and Street) Company
Evansville,IN 47715 812-759-5555
CEOs Stole.and ZIP Code Telephone Number E-mail
HYSELthlitsVaRANToRtsyaalia-t-‘-2,=-MIXitase-_,W40,1reaelait-aaa.atitTfIEWE-RiMENitiE.Tairg-Si
Flizaheth Lynn Mel ean Kenneth Gregory lAhrk
Seller 1-Nam.a appears on conveyance document Seger 2-Name as appears on conveyance document
422 Johnson Ave 422 Johnson Ave
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670 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
and complete as required by law,andjszprepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
y,_ v "in-/ J 44 Git,„,
i
, .,,,„„, of Seller t )(Signature of Seller
Fli7aheth I ynn Mc!pan I i--i-7 Kenneth Gregozals
Printed Nome of Seller Sign Date(Mm/DD/TIT) Printed Name of Seiler Sion Date(MWDD/YITI)
1FXBIMR(S)latrAi4TEEISIT APPLICAtrabNiii;PkbitilttiritAkogoli Lilt ii.18;:;11YENtIMALalift8MsAiiktiAPalitilarZiali
Ira J.McGill •
mow I-Name as appears on conveyance document i Lttryer 2-Name as appears an 'a . =tent
1603 Cottonwood Dr,
Address(Number and Street) Address(Number and Street)
Princeton.IN 47670 'JAN 1 1 2°1 7
THE SALES DISCLOSURE FORAI MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.I DENTI Pt ALL OF T110 •
n 'mr, y AUDITOR
YES NO CONDITION - YES NO CONDITIOPBS— *
igi 0 1.Will this property be the buyer's primary • IN 0 3.Homestead
residence? Provide complete address of primary • ID Fl 4.Solar Energy Heating/Cooling System
residence,including county:
11:1 151 5.Wind Power Device
422 JohnsonAve
Address(Number and Street) 0 12 6.Hydroelectric Power Device
Princeton,IN 47670 Gibson Ell Fl 7.Geothermal Energy Heating/Cooling Device
City.Stare ZIP Code County •
0 Fl 8.Is this property a residential rental property?
0 p 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide El 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.
Not available in all counties)
Address(Number end Street)
Gay,State7JP Code county
Primary Property owner contort name E-mail
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