Homestead_Mayer (5)INDIANA SALES DISCLOSURE FORM SDF ID: Ps e 2
D,PREPARER ' �.-.,�. __� - '---' .�,. ;�... �-_-' � -= � _-
Jeff Bosse. 7f.- General Manaaer
PreparerajNeSalaDiulosurtForm Title
501 Main St. Ste. 101 Bosse Title Comoanv
Addres (Number and5veet)
E-mail
E.SELLER 5 GRANTOR S = ?' ' -
Rrenda L. Jar.kson
Seller ]- �VOme as appearson cmveynnce dxumen[ Seller 2- Name as appears an comeyance dovument
358 E 790 S
Addrea (Numberand Street) Address (NUm6er and StreetJ
Ft Branch IN 47648
Ciry.
Tele honeNum6er E-mail Tefe honeNumber E-mail
Under penal[ies of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correc[
a{n-d� complete as �rpequAired by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Proper[y Sales Disclosure Ac[".
9� ha►1da cri.J.I�d.L{i�►v-�
Signamreo(Seller OCT 2 6 2pn Signamreo(Seller
Brenda L Jackson
PnnredNameo(Seller Si nDate MH/o0 Pnn[edNameo Seller Si nDate MH o0
F. BUYER S GRANTEE S-APPLICATION FOR PROPERTY TAX DEDUCTfONS-1DENTIFY�ALL ITEMS THAT APPLY �_.' - -
Amanda Maver
Buyer7 - Name asappears an rom�e}mnre dwvmen[ Buyer 2- Name asappmrs on ronveyonae dacvmen[
4467 W. State 168
Addrm'(Numbe�and5tree[J AdAres(NumberandSOeeQ
Owensville IN 47665
E�mail TNe Aoneh'umber E�mail
TNE SALES DISCLOSURE FORM MAY BE USED TO APPIY FOR CERTAIN DEUUCfiONS FOR TNIS PROPERTY. IOENTIFY ALL OF THOSE THAT APPI,Y.
YES \0 CONOITION YES \0 COYDRIOV
� 1. Will this property be the buyer's primary ❑ 3. Homestead
residence? Provide complete address of primary � � 4. Solar Energy Headng/Cooling Sys[em
residence, including county: �
5. Wind Power Device
Addrea(NumberandStreel) ❑ 6. Hydroeleccric Power Device
❑ 7. Geothermal Energy Heating/Cooling Device
Ciry, Smce ZIPCOde lounry
� � 2. Does the buyer have a homestead in Indiana [o be � $• �s this property a residentlal rental property?
vacated for [his residence? If yes, provide ❑ � 9� Would you like to receive [ax statemenGS for this
mmplete address of residence being vaca[ed, property via e-mail? (Provide contact information
including county: 6elow. Please see instructions for more injormanan.
Nat availa6le in all counties.)
Address (NUmber and Svee�)
��-i q-� 9• 2 v ti- o0 1 z-� � n z.�
Ciry, Sma Z1P Cade Counry
Pnmaryproperryownerronm¢name E�mail
Under penal[ies of perjury, 1 hereby certify tha[ [his Sales Disdosure, [o [he bes[ of my knowledge and belief, is [rue, correc[
and complete as required by law, and is prepared in accordance wi[h IC 6-1.1•5.5, "Real Proper[y Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduc[ion is
bening filed.)
S�qnaul�erl ��— T ��1`� 5(qnaoireafBuyer2/Spoux
u_
Amanda MavPr
s Stnte LastSDigicsof5ocia15ecunryNumber LastSdigitsofBuyer2/SpauseDnveri Smte LastSDigi[SafSacia(Secunry
License/ID/OtherNum6er Num6er License/lD/OtherNumber
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