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INDIANA SALES DISCLOSURE FORM SDF ID: _. Page 2
D.PREPARER
Chris Ferguson Closing Agent
Preparer of the Sales Disclosure Form Tide
501 Main St.Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville,IN 47708 812-421-4000
City,State,and ZIP Cade Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) ,. _ t r , -
.Josiah L Delong Johnna B Kramer fka Johnna B Delong
SelSd- al appears onveyance&came S _ Selja(2-Name as appeFon conveyance ocun n ace
Add`LLJ1 (Nu ber nd Street) Ty , Ad(drjress NumfVbell„(,�'tree[J j 41 41q s
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comple required by law,and is prepared in accordance with IC 6- 1-5.5,"Real Property Sales Disclosure A
a Seller �A amre of Seller
Josiah L Delong 03/12/2013 Johnna B Kramer fka Johnna B Delong 03/12/2013
Printed Name of Seller Sign Date(MM/DD/YYn) Printed Name of Seller - Sian Date(MM/oD/Yf'I
F!BUYER(S)JGRANTEE(Sgt%PPLICATION FOR PROPERTY TAX-DEDUCTIONS=IDENTIEY ALL°ITEMS THAT APPLY tin <:_
Donald Lee Brown II Kassidv C. Brown
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
3637 South 350 West 3637 South 350 West
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Princeton IN 47670
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION nut
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestea!
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑ igi
307E Olen St S.Wind Power Device
Address(Number and Street) ❑ Fl 6.Hydroelectric Power Device
Ft Branch, IN 47648 Gibson ❑ Fl 7.Geothermal Energy Heating/Cooling Device
City,State ZIP ode County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ Fl 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 12 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) (JA/N CC 49 '1 2-3d - coo ii I -0 ��
CitSrate ZIP Code County YV W - -
Primary property owner contact name 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".(Note:
Spouse information,Social Security and Driver's License/Other number are not necesass.
- • Homestead Deduction is
being$/,/s/q�ed.) .!_L- isiiki�► >• - .I .
''gnamre ofBuyer] Signature of Buyer2/pause
Donald lee Brown II 03/12/7013 Kassidy C Brown 03/12/7013