Homestead_Salemie INDIANA SALES DISCLOSURE FORM SDFID: Page2
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a`D+PREPARER ,r -Wr �,'; s srs-liN -< :�4 =-�,a'a?y.. .. ----;-"�.o-.-m
Tiffany Hoon Closer
Preparer of the Sales Disclosure Form Tide
7820 Faale Crest Blvd Ste 201 Regional Title Services
Address(Number and Street) Company
Evansville,IN 47715 (
Jacob Duncan
seller I-Name as appears an conveyance document Seller 1-Name as appears on conveyance document
6852 S 700 E
Address(Number and Street) Address(Number andStrcc)
Ft.Branch, IN 47648 .
Mare,ants ar was more,Ono sir woe
E-mail Telephone Number 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".
S tore of Seller Signature of Seller
Jacob Duncan 04-j.S-! y
Printed Name of Seller Sign Date(MM/DD/YY1T) Printed Name of Seller Sign Date(MM/DD/YYYY)
-F' Yr7(I'k(Si7GR E SI APP..IiICATION€EOR PFtDP.EKBYdPAX'DEDUCTIONS-YIDENTIRVALLFITEICIS THAHTaP.PLY..t.- - +"`
Claudius Salemie
B: -dlameaseppea nveyance document •Buyer 2-Name as appears on conveyance document
p 0.DoA2r
Addres.Number and Street) Address(Number and Street)
Haubstadt,IN 47639
E-
= 'ROPERTY. IDENTIFY ALL OF TH. - + T APPLY. FILED
YTS NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary ■ 3.Homestead Apr 25 2019
residence? Provide complete address of primary IIT a csolar Energy Heating/Coolie
residence,including county: ❑ p S.Wind Power Device
1893 S 1200E GIBSON COUNTY AUDITOR CB
Address(Number dSnet) ❑ B 6.Hydroelectric Power Device
0 d C' ,IN 47660 Gibson ❑ H /7.Geothermal Energy Heating/Cooling Device
U ,SaaZ Cade County ❑ L-,I( 8.Is this property a residential rental property?
2. Does the buyer have a homestead in Indiana to be 0 El 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
clu n ou below.Please see instructions or more information.
/n�/ / , / Not avai a counties)
Add ireUs/(/N/um/b//dstree-J// ) —, ' J711/7 ,
h L/ant /il^%v// 7 Claudius : emie 26-14-19-104-000- 644-On6
Ory,State ZIP Code County Primary prop- s owner contact 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
License/ID/Other Number