HomeMy WebLinkAboutHomestead_Vaal INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
1 D.PREPARER
Jeffrey H. Bosse Closing Agent
Preparer of the Sales Disclosure Form Title
501 Main St., Ste 101 Bosse Title Co
Address(Number and Street) Company
Evansville, IN 47708 812-421-4000 ieff.iosse.2(Wieffbosse.com
CO;State.and ZIP Lode Telephone Number E-mail
F.SELLERS)/GRANTOR(S) 1 . . _ -."7.'4'7.74::::,.. a,' _ -., r.y -
Paul F Brown Sr
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
216 S Vine St
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639
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 c plete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
L5IaF JUN 2 4 2013 Signature of Seller
•
VAI . A Qndaa $n.
Printed Name of Seller I Sian Date(MM/aD/YYYI) Printed Name of Seller Sian Date lx.v/oo/rrYll
F.BUYER(S)/GRANTEE(S),IrrAPPLICATIONLFOR PROPERflT DEDUCTIONSSIDENTIFY'ALL ITEMS THAT APPLY. ' ,.. _ 1 sr
Jecuned 1c J0.,ciA
Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1301 S. 200 W
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670
THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION I YES NO CONDITION
Q ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling System
residence,including county: ❑
5.Wind Power Device
Address(Number and Street) ❑ 151 6.Hydroelectric Power Device
City,State ZIP Code County ❑ 0 7.Geothermal Energy Heating/Cooling Device
❑ El 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property?gl
vacated for this residence? If yes,provide ❑ 0 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) �1 /y,
City,State ZlPCOde County
-coo •3 2 --09
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 requi ed by law;and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". (Note:
Spouse info mation, ci Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
b g filed
✓�1 4
5 nature of Buyer].
LYE/
Number License/ID/Other Number
)
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