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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
CHRISTINA LENFERS 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
City,State,and ZIP Code Telephone Number E-mail
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Seller I-Name as aapea a conveyance document 1/er 2-Name as appears on conveyance document
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Address(Number and Str t) Address
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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".
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ignatvre of Seller V /��y�� '] Sig re of Seller O _ /J 09 )643
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Printed Name of Seller Tit,( Sian Date l,.M/DD/Y 1 Printed Name of Seller Sian Date(MMIDD/) YII
.F.BUYER(S)/GRANTEE(S)_APPLICATIONF,OR.PROP;ERTYTAXiDEDUCTI NS-LIDDE/NTIIFX,ALL ITEEMSTHAT:AP.PPLLYp. _' ,__-__:__._
MARKS THOMPSON . (Cie)e( 1 e(/L 7t
Bayer!•Name vsa nears on conveyance document Buyer 2-A'(.'}�e as appears on conveyance document V
(P 00 AddreD(Nvm Street) TN 4764'f Address(Number and Street)
Telephone Number ' E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL.1,F HO. ' APPLY.
YE ��•-^- NDITION - 1
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S NO CONDITION B L7❑ 1.Will this property be the buyer's primary ❑ 3.Homeste • \-
residence? Provide complete address of primary III Er-4.Solar Energy Heating/.o•_,,i g System
videntir cluding u S.Wind Power I=1.•:. : --ATP
At (Numbe and Stre el L[j--I/_ ❑ [t.]-- 6. Hydroel`BpC•Vp(Sw�uev ce
r ("JI��c ❑ a/7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code ICJ
❑ I� L.Does the buyer have a homestead in Indiana to be ❑ ,�-�,'/ B.Is this property a residential rental property?
vacated for this residence? 'If yes,provide ❑ - 3 S.Would you like to receive-tax statements for this.__ . .
complete address of residence being vacated, prope?ty via a-mail?(Provide contact information
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street) '
o(C Co-/$3(0- 1Fov-Coo. aLf0 -coy
City,State ZIPCode County
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
being filed,
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