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Homestead_Eley INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER . CHRISTINA LENFERS CLOSING AGENT Preparer of the Soles 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 E.SELLER(S)/GRANTOR(S) JOHN W BENT GREGORY G- BENT Seller as ay o conveyance meal/ erl[aName as appears onQA conveyance (•ld•,xtT iu e at ` l / (✓(` ] �D A ` (/) Address Street) „ �tJ F(Nra � N14 n ` in 4) cey Crate and Code 6 5 C 5[a PCode 4 1 04 Ci3 (JaY -3 L Cs 3 � Telephone Number E-mail —1 Tel hone Number E-mail Under penalties of perjury,I t • •by certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct d co .let required b red in accordance with 11.1-5.5,"Real Pr p les Di osure Act". _ `-i.- �✓ residence? Provide complete address of primary ❑ 1374.Solar Energy Heating Ifffgggs, err D 3o' IA r�sidenc,i cl 'rig coup - ,�/ t. I' ulJ VlJ N ❑ (t S.Wind Power Device A re s Nam and Street) ^ n_ �) 4yt c,\ ("i ❑ Er 6.Hydroelectric Power Device �4�• l T,`(r ❑ 21 7.Geothermal Energy Heatin�Cpoljn9t 'j City,State ZIP ode 1VSPN ope ❑ 2.Does the buyer have a homestead inl7idiana to be is this property a residential rental grope ? vacated for this residence? IF es,provide ❑ 9.Would you like to receive it;stater n or I. complete address of residence being vacated, property via e-mai�p�'' ov . •e-• 'tG'+91tD',t motion including county: below.Please see insf171 f {sg?iffl$edrgita Not available in all counties.) Address(Number and Street) 210-I$ - 13Aio3coo 063 Oa, to City,State LP Cade County Primary property owner contact name E-mail