Homestead_Drury INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
_D: PREPARER' ,. - 1
R. Jeff Dodson Closing Agent
Preparer of the Sales Disclosure Form Title
1911 Lincoln Ave Clear Title Company
Address(Number and Street) Company
Evansville, IN 47714 812-423-8854
City,State,and ZIP Code Telephone Number
E-mail
ESEELER(S)/GRANTOR(S). • •
Frances L Barr Zella A Jaquess
Seller I-Name os appears on conveyance document Seller 2-Name as appears an conveyance document
C9 CI 77 (,, Cr.12-1-Ike,2s Ed 29c 7 I cm,re,l.-rzs el
Address(Number and Street) (Number and Street)
p2;
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and
t�ea�s�rerequired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller `(lam_ ,C,� Sgnn a of Seller —G,'IIn
' Funne,. L. PP 10-3(-aOr' , 2 w4 A. (.l& S'-3 iv/1t/ 1all
Printed Nome of Seller Sian Date(MM/DDATTY) Printed Name of Seller Sian bale(NM/OD/Yrr11
f. BUYERS)/GRATEE(S):- 1PPLI0ATI0N.E0R:PROPERTY:TAX DEDUCTIO\IS=.IDENTIFY-ALL ITEMS THQTAFP..LI
James Drury
Buyer l-Nome as appears on conveyance document Buyer 2-Name as appears on conveyan nt�—�
901 S Jefferson St �
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 NOV 6 7017
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OFTGd sG11Y,of].41NTY AUDITOR
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead
residence? Provide complete address of primary ❑ ig 4.Solar Energy Heating/Cooling System
residence,including county:
901 S Jefferson St ❑ Fl S.Wind Power Device
Address(Number and Street) ❑ 0 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 ❑ 0 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)
Lity.State ZIP Code County AO—ia' I/1-101- p01.3 Lib-10,9 8
Primary property owner contact name Email