Homestead_Brittingham INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER — —
Crystal Bassett Escrow Officer
Preparer of the Sales Disclosure Form Title ----•
5231 Oak Grove Road,Suite A Total Title Services,LLC
Address(Numberand Street) Company '""
Evansville,IN 47715 (
E.SELLER(S)/GRANTOR(S) -- y
Misty J.Stuckey
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1616 Koch Ave
Address(Numberand Street) Address(Number and Street)
Evansville,IN 47714 f
E-mail 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
• mplete as.require by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
12ft t . . ,__(' _-.i-C_._4
Signature of Seller ( Signature of Seller
Misty J.Stuckey ' i. 1 09/28/2020
Printed Name of Seger �— r Sign Date(MM/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY) 1
I F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY,ALL ITEMS THAT APPLY
Jacob A.Brittingham -_ _
Buyer -Name as appeals on conveyance document Buyer 2-Name as appears on conveyance document
11015 E 100 S
Address(Number and Street) Address(Number and Street)
Oakland City,IN 47660
E-mail Telephone Number
P Oct 05 2020 E-mail
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 ly���e�
.I(_
El1.Will this property be the buyer's primary 0 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of.primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county:
0 0 5.Wind Power Device
0 0 6.Hydroelectric Power Device
Address(NImber and Stre ) .,
na
-- (N4U6 ( , ❑ El 7.Geothermal Energy Heating/Cooling Device_CO • (�'�' / �� -`t°% ❑ 8.Is this property a residential rental proper
ty
City, and Count
y
ty ❑ 0 9.Would you like to receive tax statements for this
0 Ar 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.Please see instructions for more information.
complete address of residence being vacated, Not available in all counties.)
including county
Address(Numberand Street)
26-13-13-401-001.017-006