Homestead_Portee (5) •
INDIANA SALES DISCLOSURE FORM SDF ID: 1 Page 2
Laura Rininger Closing Coordinator
Preparer 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
ES:SELLER(S)/GRA\fOR(S)I d __
Jack W Padgett
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
ddress(Nun, eraro Street) - 1 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
4reoi21JJ mplete uiv,and i repared in cordan th IC 6-1.1 .5,"Real Prgp rty Sale 0 cllosure Act".
i*lb /0 b r - h. S,z� Ai-F-4 Signature of Seller ',!
,IarkW Padgett-byKarPn•RoxeII his AIF /- I/Y7 Jack W. Padgett•by-Beverly A,Heldt his AIF 14-11-17
Printed Name of Seller Sign Da (M14/0D/MI) Printed Name of Seller Sign Date(A M/DD/YMI
;FaBUYER(S)'/,GRANTEE(S)1AP,LICATIONf-,OR-P.ROP,ERWTAXO DEDUCTIONS,--ENTIFYiAh4(TEMSiTHATt!APPLY- 7 - ._I
Ryan T. Portee
Buyer I-Name as appears an conveyance document Buyer 2-Name as appears oliggiefy 0 pf A
5251 W SR 64 Subiect to i at 8r n a o ,,;for
Address(Number and Street) (Number Address Number and Street
day of
Princeton,IN 47670 - -
THE SALES DISCLOSURE FORhl MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFYA1RC6A'THOSE T Ai Thi
YES NO CONDITION YES NO CONDITION
• • - : - h TY AUDITOR
NI ❑ 1.Will this property be the buyer's primary 0 n 1 Homestead
residence? Provide complete address of primary mi 0 •• oar nergy Heating/Cooling System
residence,including county: n
1079 W Broadway St 5.Wind Power Device
Address(Number and Street) ❑ TA 6. Hydroelectric Power Device
Princeton, IN 47670 Gibson ri
City,State ZIP Code County 0 7.Geothermal Energy Heating/Cooling Device
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property?
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) n /i-/H a_4 -0Q3. (oE Li—D=16
City.State ZIP Code County
Primary property owner contact name E-mail