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Homestead_Yount
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 7D.BREPARERS__ -__v: ,T: � .,- ,... `1. THOMAS L.MONTGOMERY GENERAL MANAGER Preparer of the Sales Disclosure Form Title -101 PLAZA-EAST BLVD.,SUITE 102 TRUE TITLE SERVICE, LLC Address(Number and Street) Company EVANSVILLE. INDIANA 47715 812-402-6555 closings(av)truetitlein.com City,State,and ZIP Code Telephone Number E-mail E:SELtIER(S)%GRANTOR(S) '` ' . ., ,_..-_r -'-- - I VAI IGHN D COI LINS MARAI U POI LOCK Seller I-Na as appears on conveyance document Seller 2-Name as appears on conveyance document 3-0t 1. yr'`A�oµE- 30/ d. V AVE.AN/.z, Address(Number and Street) Address(Number and Street) P--iD DX-F-11-2 I.l Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and co ple : as re wired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". __ a . . pi 6, p%,�tv,‘ Signals AfSeller I Signature of Seller �c VAUGHN D COWNS 05/ I5 /7017 MARALU POLLOCK 05/ !._/ /2017 Printed Name of Seller Sian Da (MM/DD/rely) Printed Name of Seller Sian Date(MA/DD/YYYY) F',BUYE-t(S)/GRANTEE(S),, ABP,CIC ATIONiFORIPROP,ERTY=TAX,DEDUCTIONS IDENTIF,1`;AE ITEMS,THAT&ABPL'Y' , _ - ROBERT G.YOUNT Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document N.4TH AVENUE, Address `�� Address(Numberand Street) Address(Number and Street) THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT A Y'. YES NO CONDITION I YES NO CONDITION "A/T)�I° 0 ❑ 1.Will this property be the buyer's primary TA ❑ 3.Homestead .17(/0/ residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling SysterP.9 residence,including county: ❑ is 301 N 4TH AVENUE 5.Wind Power Device Address(Number and Street) ; ❑ 0 6.Hydroelectric Power Device PRINCETON, INDIANA 47670 GIBSON ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State Zl/ ode County ❑ r V 2.Does the buyer have a homestead in Indiana to be ❑ B.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ IA 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 )B Address(Number and Street) q/ itio? /0/ 00/a( _/c_ Car? ROBERT G.YOUNT City,state ZIP Code County Primary property owner contact name E-mail