Homestead_Grigsby INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
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Timothy Shea 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 (
Linda S. Spear
Seller 1-Name as appears an conveyance document Seller 1-Name as appears on conveyance document
203 N Third Street
Address(Number and Street) Address(Number and Street)
Owensville, IN 47665
Mate,ono Lir cone
Telephone Number E-mai Telephone Number E-mail
Under pen ' ereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and c pieta as repui d by law, is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
nature of Seller Signature of Seller
Lin S ear 1 -I-S- IC)
Printed Name of Seller Sign Date(NM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YIW1
8 I JYER(S15WGR�G�Eh I E - I — . r. ,,
fS1r�AP.P.LICA7!ION FOS:PROP.ER•T.$�'RAX=DEDUGTIONS�IIDBNTIF,YtAL`-L�f'REtvt571FtA+C?AP.P.I.Y ,.,��.��g�r ".,
Jared D.Grigsby
1-Name as appal eyance document Buyer 2-Name asappears on conveyance document
.VD-1 _, t� S
Address(Num• and Street) Address(Number and Street)
Telephone Number E-mail
Jul 19 2019
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO PE ENTIFY ALL D C_THAT APPLY.
YES NO CONDITION S NO CONDITION
❑ 1.Will this property be the buyer's primary 0 3.Homestead ) GIBS COUNTY AUDITOR CB
residence? Provide complete address of primary ❑ B 4.Solar Energy He ng/Cooling System
residence,including county: ❑
203 N Third Street * er D vice
Address(Number and Street) . ydroelectlic Power Device
Owensville,IN 47665 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code county ❑ q 8.Is this property a residential rental property?
❑ ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail? ' contact information
complete address of residence being vacated, below.Pleas see instructions for coo ormation.
including county: N -Ocailable in all counties.)
Address(Number and Street) Jared D. rigsby 26-17-12-202-000 . 017-022
City,State ZIP Code County Primary property matt name E-m
License/ID/OtherNumber