Homestead_Dougan (6) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER -
Chris Ferguson Closing Agent
Preparer of the Sales Disclosure Form
Tide 501 Main St.Ste 101 Bosse Title Company
Address(Number and Street) Company
Evansville,IN 47708 812-421-4000
City,State,and ZIP Code Telephone Number E-mail
F.SELLER(S)fGRANTOR(S) -
Nathan.1 Coleman Linda J Coleman
Seller ii appears on conveyanced merit Seller 2-Name as appears on conveyance document
4' . <?•8� � 5$ Po. t3of 410 V5.5"
Add (Number and Street) (Address(Number and Street)
c_tev�'\
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and_co\nplete as requ' ed�by llaaw a, rid is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Siglierre_/fS lllllle"1\r„ `•# /,�,_• •
( nature of Seller-�•C
Nathan J Coleman 08/09/2013 I indaJ Coleman 08/09/2013
Printed Name ofSeller Sign Date IMM/DO/YYYn Printed Name ofSeller Sian Date tM.a/aa/YM1
F.BUYER(S)/GRANTEE(S)=APPLICATION FOR PROPERTY TAX DEDUCTIONS_IDENTIFYALL ITEMS THAT'APPLY.:-,`` . ..
Rita S. Douaan
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
1387 E.Taftown Rd.
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY._IItf,NTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary I ig ❑ 3.Homestead t residence? Provide complete address of primary 4.Solar Energy ooliD
residence,including county: ❑ 0 YY��
401 Johnson Ave. S.Wind Power i
Address(Number and Street) ❑ MI 6.Hydroelectric Pow f,pevici2013
Princeton, IN 47670 Gibson W ll 1
City,State ZIP Code County ❑ 0 7.Geothermal Ener eaung/Cooling Device
❑ 12 8.Is this property a r
Z ❑ C2�Does the buyer have a homestead in Indiana to be
dentia re operty?
vacated for this residence? If yes,provide El 0 9.Would you like to sikeigtiqzr this
complete address of residence being vacated, property viegg1$d71F1(P.AWIgc'6rAblY n ormotion
including county: below.Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
C •105.,.., di-Id- D81-,,, o3 —oa/. 33S -oat?
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 ecurity and Driver's License/Other numbers are not necessary if no Homestead Deduction is
bei e .) n
`j/
�naat—reafBUyerl Signature ofDuyerz/Spouse
Rita S Dungan 08/09/201'1
------___ Number License/ID/Other Number