Homestead_Davis (3) INDIANA SALES DISCLOSURE FORM 5DPlR: Page 2
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THOMAS L. MONTGOMERY GENERAL MANAGER
Preparer of the ules Disclosure Form Title
101 PLAZA EAST BLVD..SUITE 102 TRUE TITLE SERVICE. LLC
Address(Number and Street) Company
EVANSVILLE, INDIANA 47715 812^102'6555 dooinns(@truoti |oinznm
C:t;State,and ZIP Code Telephone Number E-mail
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TERRY K TODD MARY F TODD
Seller I Name as appears on conveyance document Seller 2 Name as appears on conves'ance document
108 South Cross Street 108 South Cross Street
Address(Number and Sn,w Address(Number and Street)
Under penalties of perjury,)berrhyccrtih/tbat this Sales Disclosure,to the best olmy knowledge and belief,is true,correct
and plete ired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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TERRY KTOOD 06/ /5.-/2017 WARYETMDD [,
/2017
Printed Name of Seller Sion Date/x°mMini Printed Name of Seller uo*n
iFY,1311YEk(S) RAKIFGE(S)iA9xEIGAT/88T_O <`(ERVP.ERTt(oAX(DEDUEt4ONS:7;l8ENiri �����.'�'_�`�`
KAYTLIN R DAVIS ~~ ���~� ~ ,���
Buyer I-Name as appears on conveyance document »per 2-Name as appears an conveyance document
108 South Cross Street, JUN 2 3 2017
Address(Number and Street) Address(Number and Street)
prnoci co, Indiana 47849 . -'
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THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
0 F7 1.Will this property be the buyer's primary (Z) F7 3.Homestead
residence? Provide complete address of primary l 0
4.Solar Energy Heating/Cooling System
residence,including county:
Fl 12 S.VYiod Power Device
108 South Cross Strpet ^~
Address(Number and Street) Fl tzi h.Hydroelectric Power Device
Francisco, Indiana 47649 GIBSON [ z 7.Geothermal Energy Heating/Cooling Device
City,State Z P Code County
F7 Z�0o���bebuycrhavcahomc�tcadin |ndiaoa�ohc [l IN 8.|s this proP*�ya residential rental prope�y!
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vacated for this residence? lfyes,provide 0 RI 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)
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oxrT�mn�oxvm ���������%��L~/^ \��|~�����`�� //-as
uv`State ZIP Code County
Primary-pro pert-v owner contact name E-mail
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