Homestead_Mills •
r INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
-III Shy I"'t S _..\t,}0 5,------ Closing Men!
Prepare a/the Sales Disclosure Form Title
501 Main Street Bosse Title Company
Address/Number and Street) Company
Evansville,IN 47708 812-421-4000
City.State and ZIP Code Telephone Number Email
• E.SELLER(S)/GRANTOR(S)
James Vearh as nor Per ReD Estate of Havel Vearh
Seller I-Nome as appears an ro.•ngar•ce ment Seller 2-Name as appears on cc.novnce document
1 ' [ So Y SC c24 t)S-�i--42,2><
• dress(Number and Street) Address(Number and Street)
Fot,-t 4.0 Be,cI, FL 33060
•
Telephone Number E-mail
Under penalties of p rjury,l hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
`v il,, d complete/as required by law,a d is I�repared in accordance with IC 6-1.1-5.5,'Real Property Sales Disclosure Act".
5 V.ecs- /. w: err gr Ka-
ES ; o e.L- VE ' CN
Signature of Seller Signature of Seller
\Lames Veach as per Per Rep Estate of Havel V
Printed Name of Seger Sian Datelltf/OOMTT'I Printed Name n/Seller Sian Dote Imm/DDMYf
l F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Stephanie R.Mills
• Royer l•Name as appears on conveyance document Buyer Z-.Nam,a as appears on conveyance document
.0• 4 o Yq/
Address(Number ands reef) Address(Number and Street)
Ott e•••• S
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT•''
YES NO CONDITION YES NO CONDITION ...
ilk
1.Will this property be the buyer's primary E1 ❑ 3.Homestead Mr
residence? Provide complete address of primary ❑ 4.Solar Energy Heating/Cooling System
•
residence,'including county: ❑ SE(' 42013
Go,' C, 5,-, e 1I e S f, S.Wind Power Device
4 Adis`s(Number and Street) �'' 6.Hydroelectric Power Dev'ce
f-o r f t e.^ t 4 / 6/"� Si 41 7�' y r ❑ 7.Geothermal Energy He ,yr;yrr•�rvice
Code g
City.StateZ Code (rotb(e e1 County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property Gg KDftti®7(flQlttp('grP SDb'�OR
•• vacated for this residence? If yes,provide ❑ 1 9.Would you like to receive tax statements for this
•I complete address of residence being vacated, property via e-mail?(Provide contact information
( including county: below.Please see instructions for more information.
Stephanie R.Mills Not available in all counties.)
I Address(Number and Street)
ab-l1-ts-30 -GCO. 818-fb21,0
d °°.State UPCede County
1 Primary property owner roman name EmeD
1 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
I 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.) r
Signor-t of Buyer Signature ofBu)er2/5pause
, R ..t-- Sae rt;,c R-• YLli1U fs )--7(/3
i
Number License/ID/Other Number
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