Homestead_Simmons (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2017 Page 2
D. PREPARER
Teresa S. Holifield
Preparer of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055 teresa @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Joseph E.Trotter Patricia L.Trotter
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
6769 W Stonebead Dr 6769 W Stonebead Dr
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665 Owensville, IN 47665
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct
and complete aass required by law,and is prepared in accordance with IC .1-5.5, "Real Property Sales Disclosure Act".
Sign a of Seller Signature of Seller
Joseph E.Trotter 6/19/2017 Patricia L.Trotter 6/19/2017
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
❑ 0 6. Hydroelectric Power Device
!Owensville, IN 47665 I Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device
ity, State ZIP Code County ❑ 0 8. Is this property a residential rental property?
❑ 2. Does the buyer have a homestead in Indiana to be ❑ 0 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
g1/f C /L; L„ /ai e- Not available in all counties.)
pAdddr�ss(Number and Street)
% ,fss(Numbera rid L/y) -C V/10114 AC, -/ 7 - 07-yoo - oat' yy a -a au
City,
ZIP Code Coun- Primary property owner contact name E-mail