Homestead_Pegram INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Chris Sullivan 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 (
City,State,and ZIP Code Telephone Number E-mail
Adam K.Thurston Lynden N.Thurston
Seller I-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
1681 E 1200 S 1681 E 1200 S
Address(Number and Street) Address(Number and Street)
Haubstadt,IN 47639 Haubstadt,IN 47639
mail Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my owledge and belief,is true,correct
and complete as requir aw,and is prepared in accordance�yith I 6-1.1 5.5 "R 1 Property ale Disclosure Act".
0 n
Signature of Seller Adam K.Thurston q.21'2 Slg eller
n enlure Nof S.Thurston q14- 21
Printed Name of Seller Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
�3F_BUYERGSI/GRANTEE(51+--APPIh1CAlPIONJ:FOItPROPER:RY.TAX;DEDUCTIONS==IDENTIFYF ALL_ITEMS'T1HATA'PPM. _ ,., .-__ ..
Nicholas Pegram Jalia Pegram
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
305 N 1st St 305 N 1st St
Address(Number and Street) Address(Number and Street)
Owensville,IN 47665 Owensville,IN 47665
Telephone Number E-mail
Sep 25 2020
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. �,/��
YES NO CONDITION YES NO CONDITION •"'Y�",�"F"�^
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead GIBBON COUNTY AUDITOR CB
residence? Provide complete address of primary L( 4.Solar Energy Heating/Cooling System
residence,including county: ❑ 0 5.Wind Power Device
1681E 1200 S
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Haubstadt,IN 47639 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State Z P Code County ❑ 8.Is this property a residential rental property?
❑ 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 property via e-mail?(Provide contact information
complete address of residence being vacated, below.Please see instructions for more information.
including county:
Not available in all counties.)
Address(Number and Street) 26-23-16-100-002 . 191-024
Nicholas Pegram Jalia Pegram
City,State ZIP Code County Primary property owner contact name E-mail