Homestead_Nichols (2) INDIANA SALES DISCLOSURE FORM SDF ID: 2019 Page 2
D. PREPARER
61 ales ilQ (O-tO Oetike r-
Preparerofthe Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 (812)425-0055
City,State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Austin M. Farrington Emily A. Farrington
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
10289 S Pheasant Run 10289 S Pheasant Run
Address(Number and Street) Address(Number and Street)
Haubstadt, IN 47639 Haubstadt, IN 47639
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".
itifr
Sign ture o/ ell r /' Signature/di eller
Austin M. Farrington I I )C7I —r Emily A. Farrington 311 if;onPrinted Name of Seller Sign Date MM/DDNY Y) Printed Name of Seller- Sign Date( HVDDY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY AL6.I,IES A
James J. Nichols �,+
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
512 Gish Dr MAR $ 2019
Address(Number and Street) Address(Number and Street) 1
Evansville, IN 47711 -
City,State,and ZIP Code City, State,and ZIP Code
E-mail Telephone Number - . E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR-CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
Cl 1. Will this property be the buyer's primary RI ❑ 3. Homestead
residence? Provide complete address of primary 0 IS/ 4. Solar Energy Heating/Cooling System
residence, including county:
10289 S Pheasant Run 0 Q/ 5. Wind Power Device
Address(Number and Street) 0 0( 6. Hydroelectric Power Device
,Haubstadt, IN 47639 I Gibson' ❑ 111/ 7. Geothermal Energy Heating/Cooling Device
City,State,�Q ZIP Code County ❑ GO 8. Is this property a residential rental property?
❑ y _2. Does the buyer have a homestead in Indiana to be ❑ Ii 9. Would you like to receive tax statements for this
vacated for this residence? If yes,provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
Not available in all counties.-)— —
Address(Number and Street) �I t — , 8 -26-3 00 - oo2 . I68 024
City,State ZIP Code County Primary property owner contact name E-mail ,
Under penalties of perjury, I hereby certify that this SalesDisclosure,to the best of my knowledge and belief, is true, correct and
License/ID/Other Number