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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
piPREP,ARER; 6 -
Laura Rininger Closing Coordinator
Preparer of the Sales Disclosure Form Tide
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
rE;SEI:LE igiGRANTOR(S)?- - a _2 --.--257-7-7--177,77: s - 1
Terri L Devine
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
940 15th St Apt 103
Address(Number and Street) 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
and complete as-1 reggjred by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
mow r // 11
• Signature of Seller Signature of Seller
Terri I .Devine - oZ ' f 7
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYY1)
_•Fa8UYER(SjfGRANTEE(S)s'APPL ICATION_EORt PRORERTYETA\tDEDU-C-TIONSLIDENTIFYJALL:ITEIy152THATI-APPLY Wit,=--
Ashton E, Brown
Buyer 1-Name as appears on conveyance document Buyer Z-Name as appears on conveyance datum
107 S Spring St.Apt.4G
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 :4/41/ d
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT• ''.'
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead 0/T0
residence? Provide complete address of primary n 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
802 E Evans St
Address(Number and Street) n si 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson
0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑
0 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 ❑ 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)
a6 ./o7-0 2- oa- co/or -oar I
City,State ZIP Code County
Primary property owner contact name E-mail