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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
Karen S.Creek Closing Agent I
Preparer of the Sales Disclosure Form Title I
501 Main St., Suite 101 Bosse Title Company
Address(Number and Street) Company I
I
Evansville, IN 47708 812-421-4000 kthen.creek(aieffbosse.com
City,State,and ZIP Code Telephone Number I E-mail
ESEL•LERSST%GRANTOR(S).li Li- �-- - -- c -: - = —,- - -------- --`._ '. - ,— -
I
Ronald E Haines Teresa A Haines
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
527 W Tnisler 527 W Trusler •
Address(Number and Street) Address(Number and Street)
Oakland City IN 47670 Oakland City IN 47670 I
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and com e e as req fired by law,and is prepared in accordance with..IC 6-1.1-5.5,"Real P operty Sales Disclosure Act".
Signature of Seller Signature of Seller !
I
Ronald E Haines 10-17-2013 Teresa A Haines I 10-17-2013
Printed Name of Seller Sian Date(MM/DD/YMI Printed Name of Seller I Sian Date(MM/DD/nTY)
tF.i.BUYER S%GRAN,TEE(SJ,=AP.P,LICATIONIHOR+P,ROPERT:YrTAXW EDUGTIONS'LIDENTIFYrAIXITEMSITHATAPP:I Y("__'_
/Rick E.Smith-3 Leslie M.Smith
I~ Buyer-1-'men,e-asppears on conveyance document Buyer 2-Name as appears on convea,ce document
2124 W. 100 S. 2124 W. 100 S.
Address(Number and Street) Address(Number and Street)
Princeton, IN 47670 Princeton, IN 47670
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 CONDroN
Fl ❑ 1.Will this property be the buyer's primary Cm n 3.HomesteaN
residence? Provide complete address of primary ❑ 0 4.Solar Energy Heating/Cooling S stem
residence,including county: ❑
5.Wind Power /j
Address(Number and Street) El 611 6. Hydroelectrtle rjc
❑ Is 7.Geothermal nergy Heating/Co ling Device
City State ZIP Code County 1 �It
d ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property aj`[le$tf�F+� I property?
vacated for this residence? If yes,provide ❑ 0 9.Would you Iike to receive tax sta e -nts for this
complete address of residence being vacated, property via e�mai i Pre 4,5,j- tact information
42-0 O
including cou tyr'� 6elow.Pleaseseei •;pbr psis(yf$tmation.
Rsoeve I* b+rt V e Not availabtj$$ONV .
Address(Number and Street)
rnE. Verne,, 27J '4 Kozo Posey / 4 . ,//V-boo ! atb . ,oZ4 -a 5
Cit,State ZIP Code Coun
at