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Homestead_Helton INDIANASALES DISCLOSURE FORM SDF ID: Page 2
LD?:PREPARER'' • b `- ` , -- - - - - -- — _- 7 -",'— 1
Timothy Shea Closing Services
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville, IN 47715 (812)759-5555 closings@.regionaltitlellcom
City,State,and ZIP Code Telephone Number E-mail
Isaac S. Birch Sandra L. Birch
Seller I-Name as appears on conveyance document Seller I-Name as appears on conveyance document
2510W800S 2510W800S
Address(Number and Street) Address(Number and Street)
Ft. Branch, IN 47648 Ft. Branch, IN 47648
State,and LIP Lode mate,and Lip was
(
li
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an complete s required by lave,and is prepared in accordance with IC 6-1.1-5.5,"Real roperty Sales Disclosure Act".
l
-Ca- .�SR—/p Reis '4' o `it'cA, Q
Signature of Sell- t5ignature of Seller/ 4 Ly fiIsaac'S:Birch 0g/2G/.�/2 (5andra,L.,Birch og 9/ I�
Printed Name of Seller Sign bate(MM/DD/Yrrq • Primed Name of Seller Sign te(MM/OD/Ym7
SENBUYER'(SY/GRANTEEfS1a-AP.ELICATIOMEORtPROPERTalAX6-15EDUCTIONS--IDENTIEWA RiFFEMSITHAT:' L'Yt._:,—...._: _-_.J
Jordan M. Helton
Buyer I Name as appears on conveyance document Buyer 2 Name as appears on conveyance document �t
4000 Springfield Rd. -*C+
Address(Number and Street) Address((lumber and Street) ,5 '41.v
Wadesville, IN 47638
THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. S(r
O•rJ-
, YES NO CONDITION YES NO CONDITION Or.
n) 1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary ❑ RI 4.Solar Energy Heating/Cooling System
residence,including county: ❑
2510 Rt 800 S El 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
Ci ,State ZIP Code County
r, n ❑ 8.Is this property a residential rental property?
g '❑ 2. Does the buyer have a homestead in Indiana to be e ❑ o 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below. Please see instructions for more information.
HOOD Sori/IA-AC Pa. a '�Ngroottavailableinallcogunties.)
Address(Num an�ajStreet) rJe� �•`' -/t talc:7- 0' 00O. `I 5176ar
it CIteSV, le, IN t /�g Pc `ebi Jordan M. Helton
Ciry,State ZIP Cade 1/Counry Primary property owner contact name E-mail