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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
(.D`PREPARERy :« -° _: �°s �s�_ — 1
Becky King Closing Services
Preparer of the Sales Disclosure Form Tide
7820 Eagle Crest Blvd., Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 812-759-5555 becky.kinqOreclionaltitlellc.com
City,State,and ZIP Code Telephone Number E-mail
E:,SEL'LER(S]/GR`ANTOR(S) - _ _it T
Jodi C Luttrull
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
219S Hart St
Address(Number and Street) Address(Number and Street)
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,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
C Y P1
Si.gna reyfSeller Signature of Seller
Jodi C. Luttrell 5/12/2017
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sign Date(M.N/DD/YYY)
;Fi?EOYER(S)/GRANTEE(S)1=AP:REEICATIONCFO.RAP,ROEERVrIAXii-DEDUC-TfONSYIDENTIETA E,licEMSTHATAP,15 Y' =__ ]
David William Rheeling ' - -
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
Address(Number god Street) t Address(Number and Street)
�ritNG�iC,J ( Cr' L-11 —10
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE TFiA7L
YES NO CONDITION - I YES NO CONDITION GIBSON COUNTY AUDITOR
0 ❑ 1.Will this property be the buyer's primary 1 ❑ 3. Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
SI
219 S Hart St 5.Wind Power Device
Address(Number and Street) ❑ 12 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ 12 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ TA 2.Does the buyer have a homestead in Indiana to be n 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 ig ti
City,State ZIP Code County -I "3Q?—001 .5�-3- � •
Primary property owner contact name E-mail