Homestead_Martin (29) INDIANASALES DISCLOSURE FORM SDF ID: Paget
e .F . __. --.'"��'z3'`r`�a'{ "'---cow !'''' -tea ally `x' ..,.?{4'?': i T $ ,s-;+w� -^CrFr*er�l
D'PItEPARER�'-���'. �a,,,K �':a"`nXJ.� :�•;��`� .`A'�' �'eS�a�a�.�tz�,;x-ttirat " ra
Tiffany Hoon Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Stree) Company
Evansville, IN 47715 (
Robert M. Fichtinger Mary K. Fichtinger
Sellerl-Name as appears on conveyance document - Seiler I-Name as appears on conveyance document
lol S Polk St. 101 S Polk St.
Address(Number and Street) Address(Number and Street)
Fort Branch, IN 47648 Fort Branch, IN 47648
mare,ona LIP Lace ]
to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC -1.1-5.5,"Real Property Sales Disclosure Act".
2L 1-,r a,�,, 2 I ( 1 // ,it�v 4' .at,t - -i F-12-'
Signature of Seller `Signature of Sell r
Robert M. Fichtinger Mary K. Fic Linger
Prfnte lame4S.Ber__\ Sign Date(MM/OD/rrrl) Print NemeifSetler— . Sign Date(MM/DD/rrvr)
§F` UYERISWGRANTE fc114,APPIi1CATIONIFORiRROPERTEYGTAXIDEDUOTIONS=IIDENTIEWAI:L ITEbifi6THAWAPPLY W W
cmothy J. Martin l Sabrina L. Martin
er1-Nameconveyance document Buyu2-Name asappearr on convocument( aloof �IA W Wain
Address(Number andStreet) Address(Number and Street)
Princeton, IN 47670 Princeton, IN 47670
YES NO CONDITION / YES/
NO CONDITION JJI�Pt.1L1Rµ.P
❑ 1.Will this property be the buyer's primary ❑ 3. Homestead GI SON COUNTY AUDITOR CB
residence? Provide complete address of primary uiInca'a r..trEf eating/Cooling System
residence,including county: ❑ Q 5.Wind Power Device
101 S Polk St
Address(Number and Street) 0 El 6.Hydroelectric Power Device
Fort ranch, IN 47648 Gibson 0 El 7.Geothermal Energy Heating/Cooling Device
a sa ezlPcade County ❑ /g. Is this property a residential rental property?
0 2. Does the buyer have a homestead in Indiana to be ❑ El 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide
sperty via e-mairt(Provide_contact information
complete address of residence being vacated,
including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) 6-18-13-403-000. 104-026
Timothy J. Martin Sabrina L. Martin