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INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 ..-
;D,PREPARER % , . :- :. . -ri "
Robin Pugh TYPIST
Preparer tithe Sala Disclosure Form Title
530 Frederica Street Foreman Watson Land Title
Address(Number and Sheet) Company
Owensboro,Kv 42301 270-689-2424
City,Ssass and ZIP Code Telephone Number E-mail
E.SEELER(5)'GRANT OR(5) i_:; " '. - `: ':.<. ':..: :L
.:. ..
lags°Herne Inc Seller I-N c:
ame as appears on conveyance don:men Seller I-Nome as appears on conveyance document •
3624 WathPnc Crossing
Address(comber and Street) Address(Number and Street) •
Owensboro Ky42301
Telephone Number I f—mcil
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
. and co plete as requir l by law,a l is prepared in accordance with IC 6-1A-S.S,"Real Property Sales Disclosure Act". •
. ti. c5fTh- Signature of Seller
1, lOes�esii1 - a oc 111osiDui
P P.ed Name arSelIer k_San Do:e(NM/90/sYM Printed Name o/Seller I Sian Date(NKrLrynll
E(S)75.•APPLICATION:FORPROPERTY:TA&:DEDUCTIONS IDENTIFYiARE9TEMSTHATAPPLY , '?
. rpears on conveyance dormen t Buyer 2-Name as appears on conveyance document
7407 Meoan Brooke
Address(Number andSreet) Address(Number and Street)
THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDIGN NO CONDITION I
0 ❑ 1.%%rffl this property be the buyer's prirnaty Ef LI 3.Homestead � � •
residence? Provide complete address of primary ' C�— , -• ar Energy HI au C li S s
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residence,incl i c unty: ❑ ❑ 5.Wind Power Device
3 3�ref") C.Iuli4ar RC,\\o�
dress N-_.berandso- I /'' 1 ❑ L71 6.Hydroelectric Power�E 5 -2013
UU`o5�- ��' y N y� 1D39 G�iOSo� ❑ 0 7.Geothermal Energy Heating/Cooling Device
City State iPCode ) Count, I •
0 ❑ 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a resi tiaLre
vacated for this residence? If yes,provide ❑ 0 9.Would you lik I rec is for this
property via e tM't??CM kNTLcdkk)L)YTO$
complete address of residence being vacated, ,
n,. 1 , below.Please see instructions for more information.
{ddd���`ssr� O�Tldudiep„FO�U�n rt/� {/ t`��/IL//ITrC, ) 1� I Not available iri all counties.)
Adr V��mberan�r�()N1 ! .....7 )Ors ('Uunx >\,4 o$ —/A5,6-3o2- ooa.629-O
City,State ZIP[ode J 7 eaurry Primary properya'wner mvact name I E-mail
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