Homestead_Chumbley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -
Kathy Masterson CLOSING AGENT
Prepares of the Sales Disclosure Form Title
501 Main Street,Suite 101 Bosse Title Company,LLC
Address(Number and Street)
E-mail
E.SELLER(S)/GRANTOR(S)
Estate of Larry M Davis
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
2960 W.50 S.
Address(Number and Street) • Address(Number and Street)
Princeton,IN 47670
City,State,and ZIP Code City,State,and ZIP Code
Telephone Number 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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Michael R.Wildt,Personal Representative 10/16/2020
Printed Name of Seller Sign Date(MM/DO/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Elizabeth C.Chumbley Joshua A.Chumbley
Buyer 1-Name as appears on conveyance document Buyer2-Name as appears an conveyance document
2817 E.Cherry St 2817 E.Cherry St.
Address(Number and Street) Address(Number and Street)
Evansville,IN 47714 Evansville,IN 47714
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Oct 19 2020 E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY. /ti,
YES NO CONDITION YES NO CONDITION �j0k
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead GIBBON COUNTY AUDITOR CB
residence? Provide complete address of primary
residence,including county: El4.Solar Energy Heating/Cooling System
❑ p 5.Wind Power Device
2960 W.50 S. ❑ ;1 6.Hydroelectric Power Device
Address(Numberand Street) t
❑ 7.Geothermal Energy Heating/Cooling Device
Princeton,IN 47670 Gibson ❑ 8.Is this property a residential rental property?
City,State ZIP Code County • ❑ 9.Would you like to receive tax statements for this
El2.Does the buyer have a homestead in Indiana to be I 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.)
includin c unty .
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q`, - ty/kC ` 5 26-11-15-100-000.569-027
r (NumberandStreet) //
4AJ�1/l Le 017 L{M I `'( VAP
City,State ZIP Code Coun Primary property owner contact name E-mail