Homestead_Rumade INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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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
LE4SEEER(ST4GRAnLT.OR(S)P - . .- ,a>_* _ . tr ° =., 77;7,-------.--777--77.--77-7
Clinton J Smith
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
ai91 O. loo s
Address(Number and Street) Address(Number and Street)
and eta e tired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Stan re of Seller Signature of Seller
4PJ s. .(u., -I t L /2 -, 3- 17
Printed Name of Seller Sign Date(MM/DD/YYYI) Printed Name of Seller Sian Date(MM/DD/Ynl1
F TRU,YER(S;AG-R:ANIEEE(SY A_PP,L_ICAT;ION!FOR FIROPERTPYi�TAX}QEDLIKIONS i1DENiy,2,„ TED},1 p�;y °` ,---,
Andrew C Rumade (pJ
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
120 N Seminary St �EC 1 2017
Address(Number and Street) Address(Number and Street
YES NO CONDITION YES NO ONDITION
. A ❑ 1.Will this property be the buyer's primary 10 a . .mestea.
residence? Provide complete address of primary l�
residence,including county: LI 4.Solar Energy Heating/Cooling System M-4
120 N Seminary St ❑ 0 5.Wind Power Device 1
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Princeton, IN 47670 Gibson ❑ Q 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 ❑ 12 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 o-ha o'7- ao3 ,xi. gsia—va,o
Primary property owner contact name E-mail