HomeMy WebLinkAboutHomestead_Brinker INDIANA SALES DISCLOSURE FORM SDF ID: _. Page 2
D.PREPARER
Sherri S Hudson Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main St,Suite 101 Bosse Title Company
Address(Number and Street) Company
Evansville,IN 47708 812-421-4000 sherri.hudson(@ieffbosse.com
Ciry,State.and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
David R Nuefelder Trustee of Rev Trust Agreement of DRN
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
100L15 S. Pa 'tr;4Jc. Awe
Address(Number and Sweet) Address(Number and Street)
qubstzed r =n1 474-3y
Telephone Number 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".
Printed Name ofSeller Sian Date tMM/DO/YMT
F.BUYER(S)/GRANTEE(S)'-APPLICATION FOR PROPERTY-TAX DEDUCTIONS=.IDENTIFY ALL ITEMS THAT APPLY_
Faith Brinker
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1733 S Garvin
Address(Number and Street) Address(Number and Street)
Evansville, IN 47713
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 NO CONDITION YES NO CONDITION
5 ❑ 1.Will this property be the buyer's primary 2' ❑ 3.Homestead
residence? Provide complete address of primary ❑ 5 4.Solar Energy Heating/Cooling System
residence,including county: ❑
NI
107 S West Street 5.Wind Power Device
Address(Number and Street) ❑ 0 6.Hydroelectric Power Device
Fort Branch, IN 47648 Gibson ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
Ig I, ID 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 5 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.
112,2) 3. cruJT\ Not available in all counties.)
A drsNum v
$-13 4o3_too3'?
Ciry,State ZIPCade b �a�
Counry
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 numbers are not necessary if no Homestead Deduction is
bein file
Sign tare of Buyer! Signature of Buyer2/Spouse
Fpc,# —1:).-1 11. ., oS higeLOG
Number License/ID/Other Number