Homestead_Stephens •
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Christa Kingsbury Closing Manager
Preparer of the Sales Disclosure Form Title
501 Main St., Ste. 101 Bosse Title Company
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000
City State,and ZIP Code Telephone Number Email
ET-SEDBER{Sr/GRANT°R(S) Ori 94r '. .-ti- R' tT;Tn`fi'stn:t'-'7775. . .`.—{--: i_ --.. f
Michael Clore Jeannie Clore
Seller 1.Name as appears an conveyance u en/ Seller 2-Name as appears on conveyance document
537 I�(,VI i" tl. SA./he' a.
Ad r (Number and veer) ri `7 , 9 Address(Number and Street)
Telephone Number Email
Under penalties of perjury,t hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and corn let as r q heed by law,and is prepared in accordance with 6-1.1-5.5,-"Rpeal Pr{�/o��/7e-�rt/y/Sales Disclosure Act".
o
Signature of Seller ,�' ' Si ture of Seller �I
Michael Clore 03 01'003 Je nie Clore 3/00a3
Printed Name of Seller Sian Date(.RN/DD/YYYq Printed Name of Seller Sign Date fMH/DD/Yfil
iFi!BUYER(S)/GRANTEE{S)YAP,P,LI CATION;F.OR!P.ROP.ERTYgTAXDEDUGTIONStIDENTIF;Y/AL•L9TEMSCTHATiAPPL'Yt' .. -
Linda Stephens
Buyer I.Name as nnn.nnnn conveyance document. Buyer 2-Name as appears on conveyance document
/oo4 24 et
Addr.IN,,m ,_d Cr.-..,' - Address(Number and Street)
h A ✓A.Art_. - I (174 9C7
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES 0 CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary at ❑- 3.Homestead
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System
Jr3�
residence,including county:
w S f 6y ❑ p(''�''S.Wind Power Device
(h'v beta scree ^7 6 ❑ L!S 6.Hydroelectric Power Device
-� �U `��� v/ ��y�' ❑ t❑' 7.Geothermal Energy Heating/Cooling Device
city,state ZIP Code County
❑ Er" 2.Does the buyer have a homestead in Indiana to be El L�I/ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ [P 9.Would you like to receive tax statements for this
• complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) •/.,(�/�? (Q� C.110 U CM ry(`` rl�
-- -- Stare ZIP Cade ` -\ `V I — it M. 3`^'
County
Primary property owner contact 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 complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".(Note:
Spouse information,Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being file 9,)
f
- as All_ r ,
,snawre of Bu -rl l �/ � Signature ofBuyer2/Spouse
O
I inda Stephens /Kj/�11/ (/
Last 5 digits of Buyer 2/Spouse Driver's State Last 5 Digits of Social Security
License/ID/Other Number Number License/ID/Other Number \w'*\\
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