Homestead_Byers (4)!
�l.
�—IND
1 U. Y
SALES DISCLOSURE FORM
RER . ,, � -- _
Dittlosure
dddress (A'umber and Svee[)
SDFID:
. -. __. -,-. � -. � '-��.3'.'�r.
General Manaaer
iitle
Bosse Title Comoanv
Compvny
Evansville. IN 47708
Emoil
Sm[q and
$1/er 2� Name os appeurs w mnveyanre daavment
Address (NUmber and Svee[)
Ciry, Smte, and ZIP lade
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complet�{as required by law, and is,pre{i�red in accor�lapce with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
PkOPERTY. IDEMIFY ALL OF THOSE THAT APPLY.
� U 3. Homestead
� � 4. Solar Energy Heating/Cooling System
� � 5. Wind Power Device
� � 6. Hydroelectric Power Device
❑ ❑ 7. Geo[hermal Energy Heatlng/Cooling Device
� � 8. Is this property a residential rental proper[y?
❑ ❑ 9. Would you like to receive tax sWtemenCS for this
property via e-mail? (Provide contact in�ormatron
6e(ow. Please see instructions for more informadon.
Not available in all munties.)
/ � .�
� I ♦ �// I �� I
name E-mail
Under penalties of perjury, t hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Distlosure Act". (Note:
Spouse informa[ion, Social Security and Driver's License/O[her numbers are not necessary if no Homestead Deduction is
being filed.)
Gr/f�i,on� Gt�. ��l�—
_ SignaNreofBUyer] JUL 1 3 �1�
Sign Da[e (MH/DO/YYYYf
LostSdigicrofBuyerlDriveF's Smte LastSDigiuof5xia15ecuriryNumber
License/lD/Other Num6er
\y�.��l.i"0.-
Sigmmr o ye¢/Spause %
Znr ByPrs �'�I � � `012
P�Inted
(� �
Las[SdigitsojBuyer2/SpouseDriver's Stnte LasfSDigimo/SaialSecunty
Number Liceue/!D/OtherNumber