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Homestead_Hedge (6) • INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER Karen Creek Title Agent Preparer of the Sales Disclosure Form Title 501 Main Street,Suite 101 Bosse Title Company,LLC Address(Number and Street) Company Evansville,IN 47708 ( E-mail E.SELLER(S)/GRANTOR(S) Jennifer R.(fines)Summitt Seller I-Name as appears on conveyance document Seller2•Name as appears on conveyance document --39S r.R 015 O Ftw. • Address Number and Street) Address(Number andStreet) mall 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 re uired by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". II." AVill1444-4-ti 121u111 Slgna ofScller �t"- Sinature of Seller Jennifer R.(fines)Summitt 12/06/2019 12/06/2019 Printed Name of Seller Sign Date(AIAI/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) F UYER(S)/GRAjEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY imothy W.Hedge Kerijean Hedge er l•Name as veyance document Buyer 2•Name as appears on conveyance document 517 Brumfiled Ave. 517 Brumfiled Ave. ❑ 1,Will this property be the buyer's primary 14 ❑ 3.Homestead GIBSON COUNTY AUDITOR CB residence? Provide complete address of prima residence,including county: Elergy Heating/Cooling System ❑ 0 5.Wind Power Device 214 E.Walnut St. 0 El 6.Hydroelectric Power Device Address(Number and Street) 0 ❑X 7.Geothermal Energy Heating/Cooling Device Princeton,IN 47670 Gibson ❑ ❑X 8.Is this property a residential rental property? City,State ZIP Code County ❑ 0 9.Would you like to receive tax statements for this 0 EI 2.Does the buyer have a homestead in Indiana to be property via e-mail? (Provide contact information vacated for this residence? If yes,provide below.P! or more information. complete address of residence being vacated, N vailable in all counties.) including county: Address(Number and Street) 26 12-07-201-000. 683-028