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Homestead_Osborne (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER Chris Ferguson Closing Agent Preparer of the Soles Disclosure Form Title 501 Main St.Suite 101 Bosse Title Company Address(Number and Street) Company Evansville,IN 47708 812-421-4000 City,State,and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S), - • - Nathan R Rich • I indsay R Rich Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 4654 Watertower r,l - -I. - Address(Number and Street) • Address(Number and Street) Haubstadt IN 47619 Haubstadt IN 47639 Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and y [e as required taw,and is prepared in accordance with C15,"Real Property Sales Disclosure Act". Signature o/Seller�j—� - 'Signature ofSellerJ' M�`vh Nathan R Rich 07/31/2013 Lindsay R Rich 07/31/2013 Printed Name of Seller Sign Date ptn/DO/YYYY) Printed Name of Seller Sign Date(AIM/DO/MY) F:BUYER(S)/GRANTEE(S)'.r APPLICATION FOR PROPERTY.TAX DEDUCTIONS=IDENTIFY ALL ITEMS THAT APPLY 1 C'.. .' : - - Scott A.Osborne Nathalie S.Osborne Buyer I-Name as appears an conveyance document Buyer 2-Name as appears on conveyance document 115 S.Jeremy Lane 115 S.Jeremy Lane Address(Number and Street) Address(Number and Street) Haubstadt,IN 47639 Haubstadt, IN 47639 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary N ❑ 3.Homestead residence? Provide complete address of primary ❑ Fl 4.Solar Energy Heating/Cooling System residence,including county: ❑ IN 9654 S Watertower Ct 5.Wind Power Device Address(Number and Street) ❑ is 6.Hydroelectric Power Device Haubstadt, IN 47639 ❑ 0 7.Geothermal Energy Heating/Cooling Device City tate ZIP Cade County El❑ ,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 ❑ 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. IS 5. 3trzei LK ul tJC Not available in all counties.) Address(Number and Street) R11II5T1?DT IN 17103c{ GL 35°14 a t 3 L.-Zoo 0o c .`13 -7 oa5L City,State ZIP Code 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 ce=eics b5 i filed.) a Abtinatitis Caws Lsignaaire ofBuyerI - tS(gnature ofBuyerT/Spous`_ Scott A Osborne 07/31/2013 Nathalie S Osborne 07/31/2013 iv\