Homestead_Smith (78) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
SD $REPARERi -'7` 7277,-7, .. . . _ z �F 77, _a: "`177- . , • ,
THOMAS L.MONTGOMERY GENERAL MANAGER - .
Preparer of the Sales Disclosure Form Title
- - 101 PLAZA EAST BLVD.;SUITE 102 - TRUE TITLE SERVICE. LLC - - - -
Address(Number and Street) Company
EVANSVILLE, INDIANA 47715 812-402-6555 closincisetruetitlein.com
City;State,and ZIP Code Telephone Number E-mail
.t".--r .737.:
E SECLER(S)/,GRAA�TOR(S)1 `,T'_- t -4—� _} �. ?:- ; a 1 ... _ ,. - - - ,y.-
RICHARD D Gil MORE MEI ISSA S GII MORE
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
117 S BROADVIEW CIRCI F DRIVE 117 S BROADVIEW CIRCI E DRIVE
Address(Number and Street) Address(Number and Street)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
•,- �L-e-,:- 's ,LzI .{, Sc ff1ab.azza S C 0t--1
Signature of Seller Signature of Seller
RICHARDD GIl MORE IC) / a‘ /2017 MELISSAS GII MORE /0 I (.. I2017
Printed Name of Seller Sian Date(MM/DD/YYYY) Printed Name of Seller Sian Date WMM/DO/YYYYI
'tFsBUYER_(Sl,GRANTEE(S)WAPPLI6ATf ONIFORiPROPERT>YgF AX'OEDUC-TIONSEFDENT.IF, A'Brfril EMSiSTHATCA$PEY! r
CODY G. SMITH MACKENZIE R. SULLIVAN
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document qy��
117 S. BROADVIEW CIRCLE DRIVE. 117 S. BROADVIEW CIRCLE DRIVE. ��Y`Y
Address(Number and Sweet) Address(Number and Street)
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAUA� � . V//
YES NO CONDITION I YES NO CONDITION �(1,
"AA/-..
Fl 111 1.Will this property be the buyer's primary 0 ❑ 3. Homestead S-
residence? Provide complete address of primary El 4.Solar Energy Heating/Cooling Systek..
residence,including county: ❑ R
117 S BROADVIEW CIRCI F DRIVE S.Wind Power Device
Address(Number and Street) ❑ Z 6.Hydroelectric Power Device
PRINCETON. INDIANA 47670 GIBSON ❑ Ilij 7.Geothermal Energy Heating/Cooling Device
City,StateZr ode County
❑ r2.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 ❑ 2 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) 210— I )-j a -30 1 Od a . (a 9 a) 0,8
CODY SMITH&MACKENZIE SULLIVAN
City,State ZIP Code County
Primary property owner contact name E-mail