Homestead_Boling (3)v
INDIANA SALES DISCLO$URE FORM SDF ID: Pa e 2
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SETTLEMENT AGENT '
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20 MAIN STREET, SUITE 1307 EXPERT TITLE SERVICES
Addres (Number and Street) Compvny
EVANSVILLE INDIANA47708 (
E-mail
..E. SELLER S � GRANTOR S �� _ .'- . ; �=.._ '.a. �..< .,_.�_� --, ..,.,_ `-�. . '> .'-.� � � �: _ �a �.�c,F�_.
DE861E SMITH
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Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and com [e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[".
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QEBBIE SMITH 7' 3 �-% �
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S GRA �� PLICATION•FORPROPERT,Y.TAXDHDUCTIONS-tD6NTIFY.4LL,ITEMSTHATAFPLYr.
ZACKARY A. BOLIN SAR.4H M.E. BOLING
Buyerl-Nameasappmrsonronv ment Buyer2�Nameasappearsonconveyanredoa+men[
CE STREET 1108 RACE STREET
Addras (Numberand Sveet) Address (A'umberand Street)
°RINCETON. INDIANA 47670 PRINCETON. INDIANA 47670
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THE SALFS DISCLOSURf FORM MAY BE USED TO APPLY FOR CERTAIY DEDUCf10Y5 FOR THIS PROPERTY. IDEHTIFY ALL OF THOSE THAT APPLV.
YFS RO COYDITION YO COYDITIO,
�✓ � 1. Will [his property be [he buyer's primary Q✓ ❑ 3. Homestead
residence? Provide complete address of primary 4. Solar Ener� Heating/Cooling System
residence, including county/�
/' �� Q n c e �}�t��[(� � � S. Wind Power Device
ACdren(h'umberand5tree[) " � d,,,���/// 6. Hydroelectric Po�ver Device
� • �" , `� ❑ �7. Geo[hermal Energy Heating/Cooling Device
Ciry,Sm[e l ode lounry
� 2. Does the buyer have a homestead in Indiana to be � �s [his property a residen[ial rental property?
vacated for [his residence? If yes, provide ❑ � Would you like to receive tax s[atements for [his
complete address of residence being vacated, property via e-mail? (Provide con[oct information
including county: below. Please see instruc[ions for more information.
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Addras (Number and Stree[) �/"�' � /� ��p � (/1 U�� ��/ / '"`�" �
City, Smte ZIPCOde lounry
Pn'marypropertyawnermmm �ame E-mail
Under penalties of perjury, 1 hereby certify tha[ this Sales Disclosure, to [he best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1-S.S, "Real Property Sales Disclosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deducdon is
being filed.)
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