Homestead_Fason INDIANA SALES DISCLOSURE FORM SDF ID: Paget
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Deena Hendrickson 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 closingst&egionaltitlellcom
City,State,and ZIP Code I Telephone Number I E-mail
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Damon L. McEllhiney Levyn A. (Bertram)McEllhiney
Seller I-Name as appears on conveyance document Seller I-Name as appears on conveyance document
642 \V Park Avenue 642 W Park Avenue
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 I Princeton, IN 47670
"
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and corn lete as required by law,and ' -prepared in accordance with IC .-1.1-5.5,"Real Property Sales Disclosure Act".
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C9gnaNv ofSeileq"' t f� /y `�etureofS I � � /
(Damon L. McEIIIii ey) 0,1,2S/200 [revyniA.-(: am),McEllhineti'� /` 0/%5/z19
"Pnnred Name of Seller ign Da e(MM/DO/YYYY) Printed Name of Seller Sign Date(„((IM/DD/YYYY)
Ft •YE 7frRAh�TEE(SlL'AP L llOON;FO P.ROPERllita MEDUG-TIONSIDENTI ( ��j1t, MS'��-7i-$11 I '.L'w '.-F
Phili Eason R 8 f l •
yerl-Name as appea on conveyance document Buyer 2-Name as appears on conveyance ocument�}t
Address(Number and Street) Address(Number and Street) JAN 3 0 [Ot9
Princeton, IN 47670
Telephone Number GIBSON COUNTY HUUI I UN E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FORT PROPERTY. IDENTIFY ALL OF T HOS TAPPLY.
YES NO CONDITION YES NO CONDITION
di 0 1.Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary ng/Cooling System
residence,including county: ❑
642 W Park Ave 0 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
A ❑ 8.Is this property a residential rental property?
Q Eld 2. Does the buyer have a homestead in Indiana to be ❑ 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 - at1. tact information
ncludingcounty: helm ease see instructions for mor - rmation.
t available in all counties.)
Address(Number and Street) Philip Fas n 212- //- /3-242-002, - D2-r�
:
City,State ZIP Code County Primary property ow tact name E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note:
Number License/ID/Other Number