Homestead_Helfert INDIANASALES DISCLOSURE FORM SDF ID: Page 2
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Tiffany Hoon Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services •
Address(Number and Street) Company
Evansville, IN 47715 (
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Jeremy Curl Dana Curl .
Seller I-Name as appears on conveyance document Seller I-Name as appears on conveyance document
7999 SR 165 7999 SR 165
Address(Number and Street) Address(Number and Street)Owensville, IN 47665 Owensville, IN 47665
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct
and omplete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Rea Property Sales Disclosure Act".
Sign urea( eller -0Gm6. C_KSignature of Seller /�
Jere y Curl O 9-0/9 Dana Curl iO1o/L/�1 c/
Printed Name of Seller Sig Date(MM/DD/Ym) Printed Name of Seller Sign Date(MM/OD/vrvv)
V-- UYER(S1f/ - TEE(SIE--SAP.PIIIDATIONJFORiFROPERT=Y l'illCDEDUGTIONVIIDENIIIIRYAGii PE1viSAINA APIV.W `k"'
Michael Helfert
appears on conveyance document Buyer 2-Name as appears on conveyance document
6610 St. Wendel-Cynthiana Rd. FILED
Address(Number and Street) Address(Number and Street)
Poseyville, IN 47633
Jun 13 2019
PRQBF.it'IY.IDENTIPY-*U OF THOSE THAT APPLY.
Y NO CONDITION ESN YES NO CONDITION \\
❑ 1.Will this property be the buyer's primary / [ ❑ 3.Homestead
residence? Provide complete address of primary �; c I ca..ng/Cooling System
•
residence,including county: ❑ Q 5.Wind Power Device
7999 S SR 165
Address(Number and Street) " 0 Q 6.Hydroelectric Power Device
Owensville, IN 47665 Gibson 0 Q /7.Geothermal Energy Heating/Cooling Device
City,State ziP ode County 0 'L-I 8. Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ Q 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 i more information.
Not avail in all counties.)
Address(Number and Street)
Michael Helfert 26-17-19-200-000. 344-02I�
CIO.,State ZIP Code - County Primary property owner tact name E-mail J
Number License/ID/Other Number