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Homestead_Beuligmann INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 Becky King Closing Services Preparer of the Sales Disclosure Form Tide 7820 Eagle Crest Blvd., Suite 201 Regional Title Services, LLC Address(Number and Street) Company Evansville, IN 47715 812-759-5555 becky.kingeregionaltitlellc.com City,State.and ZIP Code Telephone Number ._ E-mail ESELER(S GRA\TOR(S]--� a -- .— g. : _ : r t' , "�'-¢x �a "_�_ James L Sparks Macy 0 Snarks Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 2193 E Presley Dr same Address(Number and Street) Address(Number and Street) HaubstadL IN 47639 Under . • allies of perjury,I hereby-certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct ant o .lete as required'by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales isclosure Act". /� Is �•`azure of Seller — (S(gnatur o eller James L Sparks 9/27/2017 Mary 0 Soaak 9/27/2017 Printed Name of Seller Sign Date(MM/DD/YYYYI Printed Name ofSeller - Sian Date(MH/DD/YYn) i_RBUYER(S]JGRANTEE(S) APPLICATION E0R1PRQBERTY TAX DEDUCTIONTaIDENTIEY,:AllE HIEN 'P, - t j Travis Beuligmann Lexie Beuligmann (- BuyerI-Name as appears on conveyance document Buyer 2-Name as appears on conveyance - merit- '--� - `r 7120 Goodman Rd. same Address(Number and Street) Address(Number and Street) bbl p 29 NI! Posewille, IN 47633 • 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 [7]j ❑ 1.Will this property be the buyer's primary Vl ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy Heating/Cooling System residence,including county: 2193 E Presley Dr ❑ ' 5.Wind Power Device Address(Number and Street) ❑ II 6.Hydroelectric Power Device Haubstadt, IN 47639 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 ❑ 8. 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 available in all counties.) Address(Number and Street) City,State ZIP Code County aeo -a3-110-aeo-�i. gD-pay Primary property owner contact name E-mail