HomeMy WebLinkAboutHomestead_Smith (71) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:PREPARER
Jeff Bosse Closing Agent/General Manager
Preparer of 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 E-mail
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F.SELLER(S)/GRANTOR(S) .
David Aaron I ewis
Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
112 Broadview Circle Dr
Address(Number and Street) Address(Number and Street)
Princeton.IN 47670
Telephone Number E-mail
Und• •enal '•s of perju , I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
a I co Ile . �ui•/d by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
-. e of Se.er— - Signature of Seller
David Aaron I Pwis AUG 3 0 2013
Printed Name ofSeller Sian Date MM/DD/1711) Printed Name of Seller Sian Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-'IDENTIFY ALL ITEMS THAT APPLY . ' .
Regina Gail Smith -.
Buyer 1-Name as appears on conveyance document Buyer 2-Nome as appears on conveyance document
308 E. Vine Street/PO Box 36
Address(Number and Street) Address(Number and Street)
Francisco, IN 47649
Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO COND ION ■
(21' ❑ 1.Will this property be the buyer's primary n 3. Homestead
residence? Provide complete address of primary ❑ E 4.Solar Energy t Coo S �
o residence,includin ounty: ❑
//el t t0/9-0V[Ew Cate LE DR S.Wind Power vi
�ddress(Number and StreeLL / /� ❑ NQ 6. Hydroelectric Power Dev`CQ �q
T/41NGET0N, La' 19k ? 0 C1 £scv ❑ 7.GeothermalEner§yftlsleatingCB oling Device
City,State ZIP Code County
❑
❑ ❑ 2. Does the buyer have a homestead in Indiana to be
8. Is this property a siden ' I r operty?
vacated for this residence? If yes, provide ❑ 9.Would you like t to for this
complete address of residence being vacated, property'BSfait1 t/gAWM 1 rUbrmation
including county: below. Please see instructions for more information.
Not available in all counties.)
Address(Number and Street)
a9—I 1-1 a-30 I-001 . 6 (e -0 a8
City,State ZIP Code County
Primary property owner contact name E-mail