Homestead_Hutchison INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
I D.PREPARER
THOMAS L. MONTGOMERY GENERAL MANAGER
Preparer of the Sales Disclosure Form Title
101 PLAZA EAST BLVD.. STE. 102 TRUE TITLE SERVICE. LLC
Address(Number and Street) Company
EVANSVILLE. IN 47715 812.402.6555 closines(htruetitlein.com
City,State,and ZIP Code Telephone Number E-mail
1
DWAYNE ERIC MCCULLOUGH
Seller I-Name as appears on conveyance document Seller I-Name as appears on conveyance document
104 S.Weber Drive
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639 -
State,and ZlPcode State,and ZIP Code • .
Telephone Number E-mail Telephone Number I - E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my:knowledge and belief,is true,correct .
and4omplete as re eared b law,and red in accordance with IC 6-1.1-5.5;"Real Property Sales Disclosure Act".
- Signature of Seller ._ "^-
DWAYNE ERIC MCCULLOUGH • .
Primed Name of Seller Sign Da (MM Printed Name of Seller �., Sign Dote(MMD/YY/DYY)
I F.BUY PPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEM-8 T�IATAPiti ) '
MESON B:HUTCHISON OLIVIA P. HUTCHISONa- . Lti/k—/1LJ
-
'I Bu Buyer 2-Name as appears on conveyance document -• .
104 S.Weber Drive 104 S.Weber Drive ' DEC 1 7 2018
Address(Number and Street) Address(Number and Street) ..
Haubstadt,IN 47639 Haubstadt,IN.47639 • ii r 'A�
State and ZIP Code State.and ZIP Code In
_
E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YFS 'NO CONDITION YES -IO COND ION/
❑ 1.Will this property be the buyer's primary ` ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
• residence,including county: • ❑
104 S Weber Drive 0 S.Wind Power Device
Address(Number and Street) - ❑ 0 6.Hydroelectric Power Device
Haubstadt. IN 47639 Gibson ❑ 0/ 7.Geothermal Energy Heating/Cooling Device
nty,sm ez Code c°°"ty ❑ lYJ( 8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes,provide la El 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'inforthation.
Not available in all counties.)
Address(Number and Street) Itb- 18 - 3 4:,- sea Y - 0 0 0 . a s 7 -co 9
JAMESON B. HUTCHISON R. OLIVIA P. HUTCHISON
Cf0'.State ZIP Code County Primary property owner contact name E-mail