Homestead_Nolting INDIANA SALES DISCLOSURE FORM SDF ID: 26-02-58-046-000.969-018 Page 2
iD.PREPARER-.ci>a:`'` . -e436 ,.`mss: #as .-'.sm. _. ..'4'stc"Wii .;`-YrN ie'ti;;?nom, zi-e--:..7`n.'
Colleen Dunn _ Closing Services
Preparer of the Sales Disclosure Form Title
621 Main St Ste 201 Regional Title Services, LLC
Address(Number and Street) Company
Vincennes, IN 47591 812-316-0418 colleen.dunn(aregionaltitlellc.com
co,.State,and ZIP Code Telephone Number
sig E-mail
•
ERSEL ;ER(S)/GRi1NT,O �SF M.->*5ekc- - .- -:,-. 2,---.4:7'. :i�. � . . ? aiiyk : - -i✓z..-"3:.4,, X - i: y Pn,5 21.-O!
Bradley W Cullison Timothy Alan Cullison
Seller I-Name as appears an conveyance document Seller 2-Name as appears on conveyance document
Ill `( -e Srst 1q02SE 6LUFF LA
Address(Number and Street) AB h(Nirnifreiand stieet)
�s91. /
Under penalties of perjury,I hereby certify that this Sales Disclosure,to e best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance wi C 11.1-5.5,"Real Property S s Disclosure Act".
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Signature of Seller - `, "nature of Sale; �"
Bradley W Cullisnn I I l 7 Timothy Alan Cullison - 11
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MH/DD/YYYY)
rFg BUYER[S)J,GRANTE6(S)-AP,P,LICATti FIFOR{PR'OP,ERTIYTAXaDEDUCTIONS IDENTIF,YTAI$111 M eRAT;ABPLYirs � '
Matthew Nolting Laura Nolting
, Buyer I-Name as app gars on conveyance document Buyer 2-Name as appears on conveyance docume
1CO�.7 rippeak— Ra., -1c�i7 Trlpa' Kth
Ad friss(Numbera dStreet) • Address(Number and Street)
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION
this r YES NO CONDITION FILED
r� �� 1.Will this property be the buyer's primary R' �l 3. Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,includin c unty: ❑ Q 5.Wind Power Device NOV 1 3 2017
Add Number pied Street) //JJ ,, ❑ 0 6.Hydroelectric Power Device
� n fit/ 1 4 7 ��`-f O ❑ 0 7.Geothermal Energy'7�+ ' evice
Ciry,State ZIP fade County
❑ 2. Does the buyer have a homestead in Indiana to be ❑ NI 8. Is this properWi£ rdeCII I� nt*pmpEmi?
vacated for this residence? If yes,provide ❑ s 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) ��//� 91n j//�
City,Slate ZIP Code County A- 5g_ e2:01‘7- pops 0-
Primary property owner contact name E-mail